Understanding Problem Gambling Signs, Symptoms, Diagnosis, and Causes

Problem gambling, much like many other addictions, is often misunderstood. The average person is typically quick to dismiss a gambling addict as either greedy, lazy, or naive. Unsurprisingly, preconceptions like these do very little good for the problem gambler. Instead, they only serve to stigmatize the issue further, pushing the unfortunate sufferers to the edge of society, where they are unlikely to get the help they so desperately need.

I created this article to inform and educate about the true nature of gambling addiction. After reading, I hope you will better understand, accept, and be able to start dealing with problematic gambling habits, wherever you may encounter them.

1. What is problem gambling?

Problem gambling is the overpowering urge to gamble and continue doing so for as long as possible. Problem gamblers continue playing despite any negative consequences, even when they become aware of their destructive habits.

That's because, as the name would suggest, gambling addiction is a real addiction. Players experience positive reinforcement when gambling because their brains release feel-good chemicals like serotonin, dopamine, and noradrenaline. These chemicals cause an elevated feeling called the "gambler's high," which is similar in effect to the euphoria people experience under the influence of drugs or alcohol. Gamblers get used to this high and eventually become dependent on it. They even experience withdrawal symptoms as they would with substance abuse.

So, as you can see, problem gambling is not just about money. Despite what some people would have you believe.

2. How does someone become a problem gambler?

Addiction is a complex thing. It's simply not possible to blame any singular thing for a person's addiction - least of all the person themselves. In reality, addiction results from the combined influences of biological, psychological, social, and spiritual factors (called the Bio-Psycho-Socio-Spiritual Model of Addiction) with the added element of game design in gambling addiction's case.

Problem gambling starts inconspicuously at first, typically with just a few games of chance on a night out with friends. But even these first few seemingly harmless games test the person's resilience against gambling addiction. Casino games are designed to be as exciting as possible to keep the person playing them and spending money. The first win is exhilarating, while the first loss is devastating.

Ultimately, those initial wins and losses are what keep people coming back. The winner wants to relive the thrill of winning, while the loser wants to try again and recoup their losses. This is where gambling addiction often begins.

Through the combination of casino game design and the fault of our own neural wiring, our brains get used to the release of the aforementioned feel-good dopamine, serotonin, and noradrenaline and compel us to gamble again. Psychologically, we start to obsess about the ideas of solving all our life's problems with a single big win, as well as winning what we've already lost.

Unless the gambler is either resistant to addiction or is actively pursuing safe gambling practices and using responsible gambling tools, they tend to dig themselves a deeper hole the more they play.

That's because problem gambling is a cursed cycle. Since the odds are stacked against you, you end up losing money. It haunts you, so you return to win it back. But you just lose more money. Bit by bit, you spend more of your time either gambling or thinking about gambling.

This might lead to you losing touch with your family and friends or getting fired from your job. So, you accumulate more debt. You feel anxious, afraid, and depressed. The only escape from your situation (as far as you can see) is just one big win. But it never comes. Unless you get help, you'll stay caught in this destructive cycle until you hit rock bottom.

3. The stages of problem gambling

Robert L. Custer, M.D., was the first to describe gambling addiction's development process and divide it into three parts. In doing so, he outlined the categorization used to this day.

  1. The winning stage is triggered by the gambler's first win and the release of dopamine and serotonin, which motivate them to continue gambling.
  2. The losing stage begins as soon as the player inevitably suffers their first loss of many. As they keep on losing and chasing their losses, money gets scarcer, their mental health gets worse, resulting in them becoming more and more desperate.
  3. The desperation stage is typical with anxiety attacks, hopelessness, and depression. As a consequence of their gambling, players accumulate debt, lose their job, and become isolated from their friends and family.

Custer also wrote about the problem gambler's financial spiral and gambling addiction recovery stages, which we discuss in a different article. But nowadays, Custer's isn't the only approach to gambling addiction's categorization.

The problem gambling cycle, featured by major industry players like GamCare, describes how problem gambling compulsions work on a day-to-day basis in a cyclical way, rather than Custer's linear view of gambling addiction's overall development. The problem gambling cycle consists of:

  1. A trigger that fires off a player's gambling session after a period of abstinence. It can come in a variety of forms - a thought, emotion, sound, etc. Triggers don't necessarily have to remain the same over time, and a person can have multiple functional triggers.
  2. An urge to gamble again after experiencing a trigger. This urge grows in power over time and gets continuously harder to ignore until the player gives in to their temptation.
  3. A gambling episode the gambling player indulges in after succumbing to their urges. They can either win or lose.
  4. Further gambling sessions typically follow the initial episode. If the first episode was a winning one, the player attempts to win more. If it was a losing one, they chase and try to recoup their losses.
  5. Gambling stops eventually, either for lack of money or time. However, this doesn't have to be permanent. As gambling addiction develops, the likelihood of this cycle repeating gets ever-increasingly larger.

4. Types of problem gamblers

Anyone can become a problem gambler. But some people are more susceptible to gambling addiction than others. Professionals divide problem gamblers into three types, based on the Bio-Psycho-Socio-Spiritual Model of Addiction: emotionally vulnerable gamblers, behaviorally conditioned gamblers, and biologically based gamblers. The gambler's type also explains how to treat them most effectively.

  1. Emotionally vulnerable gamblers – This type of gambler gambles to escape their negative emotions. They are typically emotionally disturbed, suffered emotional trauma in the past, have poor coping skills, and struggle with building relationships due to their low self-esteem. Through counseling, they can address their underlying emotional issues, create better coping skills, and ultimately make a full recovery.
  2. Behaviorally conditioned gamblers – This type of gambler is prone to obsessive behavior, compulsively repeating the same series of actions. They are very susceptible to environmental triggers and have trouble controlling their urges. Consultations with a trained professional are typically ideal for breaking them out of their compulsions.
  3. Biologically based gamblers – This type of gambler is a slave to their genetic "wiring." They act impulsively and are in constant need of stimulation. To treat them, a combination of medication and therapy works best.

5. The signs and symptoms of problem gambling

As I repeatedly say throughout these articles, gambling addiction affects every aspect of a problem gambler's life. Incidentally, these negative consequences serve as the signs and symptoms of problem gambling. For cohesiveness' sake, I created the following list, categorizing the signs by which part of a gambler's life they affect.

1. Wanting to stop gambling and feeling remorse after playing

Losing money doesn't feel good. No surprise there. But no matter how bad a problem gambler feels after giving into their habits, they're often unable to stop themselves from coming back for more. Continuing to engage in an activity that makes you feel bad is a clear sign of addiction.

2. Money-related symptoms

Examples: losing substantial amounts of money; chasing losses; dreaming of winning big; borrowing money for gambling; etc.

When it comes to gambling addiction, money-related symptoms are what immediately comes to everyone's mind. Money is often the initial motivator for gambling. Many people start playing because they dream of winning big and living the rest of their lives in comfort or wish to improve their own and their families' lives.

But those dreams and wishes are practically impossible to achieve. Due to casino gambling's nature, gamblers are always playing at a disadvantage, so they can only end up losing in the long run. But by the time they realize this, it's usually already too late.

By that point, they've already started chasing their losses and may be addicted. The problems just end up compounding as time goes on. Debts pile up, and the families they may have initially wanted to help end up suffering more than they would have otherwise.

3. Time-related symptoms

Examples: gambling takes up increasing amounts of time; losing track of time while gambling; prioritizing gambling over school, work, and social activities

As gambling addiction develops, the activity starts consuming more and more time. Even when not playing, the problem gambler spends much of their time thinking about gambling. This "hobby" can begin to interfere with other activities they used to enjoy, their family time, and even their work. In the most extreme cases, gamblers end up doing nothing more in their day than eating, sleeping, and gambling. And even eating and sleeping can suffer.

4. Work-related symptoms

Examples: missing work due to gambling; decreased efficiency and concentration at work; loss of professional goals and ambitions

Regardless of whether a problem gambler is an employee, self-employed, or a business owner, their career is almost inevitably going to suffer. Employees may start missing work to gamble. Self-employers and business owners might forego their responsibilities and put their enterprise in peril.

Work-related symptoms and consequences don't stop at a loss of time either. Even if the gambler spends just as much time working as they used to, their efficiency can drop due to their minds becoming preoccupied with thoughts of gambling. In the worst-case scenario, they end up losing all their drive and ambitions outside of the world of gambling.

5. Social symptoms

Examples: deteriorating relationships; social isolation; bad reputation; lying about gambling

Problem gamblers' social life tends to suffer due to their bad habits. Family members, partners, friends, and co-workers may fall out and force the gambler into social isolation. Furthermore, if a player's gambling addiction comes to light, it can tarnish their reputation.

6. Psychological symptoms

Examples: escaping real-life problems through gambling; carelessness; fear; irritability; insomnia; anxiety; depression; self-destructive and suicidal thoughts

As is often the case with addiction, gambling addiction causes its sufferers psychological distress in various ways. Individuals struggling with stress and mental health issues might see gambling as a good form of escapism. But it is a fake friend. The excitement felt during play quickly transforms into anxiety, fear, and depression as soon as money runs out.

If a problem gambler stops gambling, they begin to suffer from withdrawal symptoms, including irritability and insomnia. In combination, these symptoms can drive a gambler to the point of a mental break, causing suicidal thoughts and self-destructive tendencies.

6. How to diagnose a problem gambler

As you can see, problem gambling is no laughing matter. It is a devious and relentless enemy to battle, and unless problem gamblers get the help they need, they are unlikely to win on their own.

If you suspect you may be suffering from problem gambling, I highly encourage you to see a professional or reach out to a local problem gambling help-center. However, I understand that some may be unwilling to such measures because of a simple hunch.

That's why I highly recommend taking one or more of the several problem gambling self-assessment tests available. The most widely used is a test by Gamblers Anonymous. It consists of 20 simple yes or no questions, where 7 or more positive answers mean you may possess some problematic gambling habits. The more positive answers you submit, the more severe your symptoms are.

Note: Gambling Therapy's Self-Assessment Questions, Gamcare's Self-Assessment Tool, and GambleAware's Self-Assessment Tool work in a very similar way and are a great resource if you want to get a second opinion before deciding on your next course of action.

Should your suspicions be confirmed, and you find that either you or someone close to you is a problem gambler, I urge you to get help as soon as possible. The worst thing you can do is wait and do nothing, which will only make the situation worse. If you are unwilling to reach out to professionals for help, visit my article on how to overcome problem gambling to learn more about the preventative measures self-help options open to you.

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