Gambling involves risking something of value—money, property, or other assets—on the outcome of an event that depends on chance. Some gambling activities involve skill, and some do not. It can occur in a casino or online, with an actual game of chance, such as poker or blackjack, or with a simulated version of the game, such as an online slot machine. It can also include lottery games, sports betting, and other forms of recreational betting. Some types of gambling are regulated, while others are not.
While there are many different reasons people engage in gambling, the most common is that it gives them pleasure. The pleasure comes in part from the social desirability of winning and in part from the excitement of the risk involved. People who are genetically predisposed to thrill-seeking behaviour and impulsivity may be particularly vulnerable to gambling addiction.
The problem with gambling is that it can become an all-consuming activity and can lead to financial ruin and strained relationships. It is important to recognise that there is a problem and seek help. Counselling can help by teaching people to manage their urges and think about how their behavior affects themselves and others. It can also provide strategies to stop gambling and find other ways to deal with stress and boredom. Psychotherapy is also useful for addressing co-occurring mood disorders, such as depression or anxiety, which can trigger gambling behavior and make it harder to stop.
In the past, psychiatry regarded pathological gambling as a form of impulse control disorder, similar to kleptomania or pyromania (hair-pulling). However, it has now been moved into the chapter on addictive disorders in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders. This change, along with the high comorbidity of gambling disorder with other addictions, is intended to increase awareness and encourage screening for the condition.
Research on gambling problems is often difficult to conduct because of the complexities and reluctance of people to admit they have a problem. This makes longitudinal studies, which follow the same group of participants over time, particularly helpful. These studies can identify factors that moderate or exacerbate a person’s gambling participation and help establish causality. They are, however, challenging to mount, due to the massive funding required for a multiyear commitment and the difficulty of maintaining research teams over such a long period of time. They are also hampered by difficulties with sample attrition and the danger of confounding aging and period effects.
In addition to counselling, it can be helpful to strengthen a support network and find other healthy ways to spend time. This can be done by reaching out to friends and family, joining a sports team or book club, or volunteering for a cause. It can also be helpful to join a peer support group, such as Gamblers Anonymous, which follows a 12-step program similar to that of Alcoholics Anonymous. Medications may be used to treat co-occurring mood disorders, such at a therapist, if they are found to be triggering gambling behaviors.