Gambling addiction

Gambling can include casino games, slot machines, lotteries, scratch cards, poker, sports betting and online gambling on phones or computers. For many people it's an occasional pastime. Problem gambling describes a spectrum, from gambling that is starting to cause harm to a full gambling disorder.

Gambling activates the brain's reward system in ways similar to some drugs. Unpredictable wins, near misses and the speed of play keep people coming back. Over time, a person may need to gamble more, or with bigger stakes, to feel the same excitement, and may feel restless or irritable when trying to stop.

Sports betting addiction and online gambling addiction have become more visible as betting apps make it possible to gamble anywhere, at any hour, with features like in-play bets and instant deposits. This constant availability can make it harder to notice when gambling has crossed a line.

Common warning signs include:

• Thinking about gambling much of the time, or planning the next bet
• Needing to gamble with more money to get the same thrill
• Repeated, unsuccessful attempts to cut back or stop
• Feeling restless or irritable when not gambling
• Gambling to escape problems or to relieve low mood, anxiety or guilt
• "Chasing losses": returning to win back money that was lost
• Lying to family or others about how much you gamble
• Borrowing money, selling belongings or relying on others to cover debts
• Putting a job, relationship, studies or other opportunities at risk

Gambling problems often stay hidden for a long time because, unlike alcohol or drugs, there are few visible physical signs. Partners and families may first notice financial strain, secrecy, mood swings or unexplained absences.

There's no single cause. Contributing factors may include:

• Brain and biology: differences in reward sensitivity and impulse control.
• Mental health: depression, anxiety, ADHD and substance use often coexist with gambling disorder.
• Personality traits: impulsivity, competitiveness or a strong need for excitement.
• Early exposure: starting to gamble young, or growing up around gambling.
• Stress, loneliness or major life changes that make gambling feel like an escape.
• Access and design: easy access, rapid play, free bets and constant advertising can increase risk.
• Thinking errors: believing you can predict outcomes, that a win is "due," or that skill can overcome the odds.

Some medications that affect dopamine have been associated with impulse control problems, including gambling; anyone concerned about this should talk to their prescribing doctor rather than stopping medication on their own.

Gambling disorder responds to treatment, and many people recover.

• Cognitive behavioral therapy (CBT): the best-studied approach. It helps people identify triggers, challenge beliefs about luck and control, manage urges and rebuild a life with other sources of reward.
• Motivational interviewing: helps resolve mixed feelings about change and strengthen commitment.
• Couples or family therapy: addresses the impact on relationships and rebuilds trust.
• Peer support groups: mutual-help groups provide connection with others who understand.
• Financial counseling: practical help with debt and money management is often an important part of recovery.

There is no medication specifically approved for gambling disorder everywhere, but a psychiatrist may treat co-occurring depression, anxiety or ADHD, and in some cases may consider medication that targets cravings.

A psychologist, clinical psychologist or addiction specialist is a good first contact. In the first session, they'll ask about your gambling habits, finances, mood and support, and help you set goals.

Taking practical steps now can reduce harm while you seek support:

• Use self-exclusion tools offered by gambling sites, venues or regulators in your country.
• Install blocking software on your phone and computer.
• Ask your bank about blocking gambling transactions, if available.
• Hand over control of finances to a trusted person for a while.
• Delete betting apps and unsubscribe from marketing.
• Identify your triggers, such as payday, boredom or watching sports, and plan alternatives.
• Tell someone you trust what's going on.

Urges usually peak and then pass. Delaying for even 15 minutes and doing something else can help you ride them out.

Relapses can happen, and they're a reason to adjust your plan, not to give up.

Gambling problems are linked to higher rates of depression, anxiety and suicidal thoughts, often driven by debt, shame and relationship breakdown. If you are thinking about suicide or feel you can't go on, reach out immediately: call or text 988 (Suicide & Crisis Lifeline, US), call Samaritans at 116 123 (UK and Ireland), or call 911 or your local emergency number.

If you're worried about someone else, talk to them calmly, without blaming, and focus on your concern for their wellbeing. Protect your own finances, and consider seeking support for yourself too. Families of people with gambling problems often benefit from therapy or support groups of their own.

You don't have to wait for things to get worse before asking for help. Many people find that talking to a professional early saves years of harm.