Gambling is any activity that involves taking a risk for the chance of winning money or other prizes. It can be done for fun, to socialise or as a way to relieve boredom or stress.

If you’re worried about a loved one’s gambling addiction, seek help. Counseling is an effective treatment for problematic gambling, and it can help you deal with co-occurring disorders like depression.

Origins

Gambling involves risking money or something of value (like a car or a house) for the chance to win more than you have invested. Whether the outcome is good or bad, gambling can be fun for some people but for others it can become a serious addiction that affects work, family, and personal relationships.

The origins of gambling can be traced back to divinatory practices used in early pre-historic societies. These rituals involved casting lots – throwing objects like pebbles, sticks, bones, and other easily accessible items on the ground. The numbers on the ground were then interpreted.

Throughout history, many cultures have practiced gambling in some form or another. From rudimentary games of chance on tiles to the ancient Egyptian game of knucklebones, and scenes from Roman pottery of betting on animal fights to the medieval game of baccarat, humans have always loved the thrill of a quick win. Interestingly, it was only in the 15th century that organized gambling started to take shape with lotteries and gambling houses.

Symptoms

Gambling can be fun, but it can also become problematic. People with compulsive gambling disorder have trouble resisting impulses to gamble, which can lead to serious financial problems, work and relationship issues, and even crime or fraud.

If someone is unable to control or stop gambling, they might show withdrawal symptoms like those of other addictive substances. They may become irritable, impatient or agitated without gambling and they might not sleep well.

They might start lying to friends and family about where they are so that they can gamble. They might borrow or steal money to pay for gambling or to try to recover losses. They might hide their gambling from others or lie to employers about it.

A person who has a mental health condition such as depression or anxiety might be more at risk of gambling problems. It is important to get treatment for any underlying conditions that are contributing to the problem.

Treatment

The first step in treatment is admitting that there is a problem. Then the individual must realize that a change in behavior is necessary to overcome compulsive gambling. Treatment may include therapy, family counseling and medications.

Medications may help with co-occurring psychiatric disorders, such as depression and bipolar disorder, which are often associated with pathological gambling. Antidepressants and mood stabilizers can help to reduce gambling-related symptoms.

Comprehensive treatments move through three stages: acute intervention, rehabilitation and maintenance. Individuals who have a gambling disorder should be carefully assessed to determine what type of treatment will work best for them.

Brief treatment might consist of a 10-minute conversation with a therapist and limited motivational enhancement therapy. Other examples of brief treatment are providing information about harmful consequences of excessive gambling and offering advice for reducing gambling-related harm. In one study, Myrseth et al. [31] randomized participants to either group CBT (3 h per week for 8 weeks) or waitlist control, and found that both groups showed similar improvements in gambling severity and craving at post-treatment and six-month follow up.

Prevention

While many studies have been published on the subject, the effectiveness of gambling prevention initiatives remains controversial. Most interventions fall into the category of risk reduction, aiming to reduce the probability of gamblers experiencing harms rather than trying to prevent gambling-related addiction [1, 2].

There are some protection strategies that appear effective at reducing the risks associated with gambling. These include self-exclusion, avoiding high-risk situations (such as using credit cards or carrying large sums of money), and finding alternatives to gambling activities for socialising and escaping emotional distress. Talking about gambling with someone who won’t judge you can also help if it is causing problems.

It is essential to identify the contexts in which gambling affects people and develop policies to limit its accessibility, increase responsible gambling, and minimize the impact of gambling-related harm. This requires a clear distinction between personal, interpersonal and community/societal impacts of gambling. However, the conditions for implementation are complex and may conflict with philosophical considerations about the ‘nanny state’ or vested financial interests promoting gambling.