Pathological gambling or gambling belongs to Impulse Control Disorders (TCI), which are generically defined as the inability to resist an impulse, stimulation or incitement to commit a harmful action for the individual himself or his environment.

Most of these disorders are preceded by an inner emotion (excitement or enthusiasm), followed by satisfaction or release during the act itself. After the action, episodes of remorse, recrimination or guilt may or may not occur. Apart from gambling, pyromania and kleptomania , they are some of the most well-known TCIs.

What is compulsive gambling?

Gambling is typified as a behavioral disorder and has even been seen as a chronic and growing mental illness. The individual experiences a compelling desire to intervene in games of chance. The course of the pathology is distinguished by serious problems in limiting the amounts of money in gambling and the hours devoted to gambling.

The concepts refer to a kind of dependency or addiction that causes damage to the player or third parties , in various ways. Pathological gambling maintains the same pattern as addictions to toxic substances, which is why it necessarily falls into this class. It is then defined that pathological gambling is characterized by being:

  1. a) an Impulse Control Disorder (TCI), due to the inability of the individual to retain control over the gambling activity and stop.
  2. b) a non-toxic addiction, as it is similar to drug dependence.

Individuals follow a behavior similar to drug addicts. That is, they go through the following sequence:

  1. They experience an urge to repeat maladaptive behavior.
  2. They feel exalted until they carry out the behavior.
  3. They recognize themselves relieved, but temporarily.
  4. They get a kind of feedback as they gradually regain momentum.

The process of strengthening the addictive behavior of the gambler goes through the same stages of drug addicts:

  1. Habituation accompanied by reinforcement occurs , as in chemical dependency. The individual gets used to the game, creating behaviors by repetition.
  2. The gambler’s brain responds to conditioning, produced by environmental or internal signs . For example, the neon lights in the street or the feeling of anxiety, unleashes the desire to play.
  3. As in the consumption of toxic substances, tolerance develops. The individual needs to increase the stakes more and more and dedicate more time to the game.
  4. The subject experiences withdrawal symptoms when he stops playing for a few days.
  5. There may be an obsessive-compulsive category disorder . Gambling addicts may present obsessive thoughts (usually denying, cursing) due to gambling and their ability to discern disrupted, which could be interpreted as control mechanisms corresponding to a trauma.

What are your symptoms?

There is a body of differential criteria that allow diagnosing the presence of a behavior disorder of this nature. Taking these signs into account, the diagnosis differs from a manic episode.

The most important component of compulsive gambling is a non-adaptive, recurrent and prolonged gambling behavior that negatively transforms the subject’s life, work activities and family environment.

In this group, a series of useful criteria for the diagnosis of pathological gambling can be distinguished . In order for a person to be diagnosed as a gambler, they must meet five or more of the following criteria:

  1. Interest in gambling (projecting ways to get money from gambling).
  2. Spending money in the game exponentially, in order to achieve greater and greater pleasure.
  3. Useless efforts to master and stop the habit of gambling.
  4. He shows irritation of humor when he stops playing.
  5. Play is used to cover up conflicts or to calm negative feelings (regrets, anxiety, discouragement, etc.)
  6. The player returns to the game to try to recover the money spent and win more.
  7. The individual lies to his family, friends, and even the therapist, about his level of dependence on the game.
  8. The subject engages in criminal practices, such as theft, falsification of documents, fraud, etc., to obtain the economic funds that allow him to continue gambling.
  9. The person is alone because he has sacrificed interpersonal relationships for the game. In addition, you have lost your professional or work ties.
  10. The subject places the responsibility of obtaining the money in his immediate environment, which helps to alleviate the economic deficiencies caused by his addiction to gambling. This is the so-called “parachute drop” strategy.

In short, gambling addicts may suffer from a thought disorder. Gamblers are likely to remain in denial, get carried away by superstitions, express oversized confidence, and self-centered and narcissistic behaviors.

Instead of blaming gambling for their bad fortune, they believe that the solution to their problem is to win the money in large quantities. In addition, gamblers generally display a competitive and restless personality. Its excesses and continuous stress can manifest itself in diseases of the digestive tract and the cardiopulmonary system.

In the clinical pictures of gambling addicts , mood disorders, attention deficit with episodes of excitement, associated with the intake of alcohol, drugs and antisocial behaviors can be confronted.

Although in the world the disorder is more widespread among males , it is also present among females. Regarding the preferences in gambling and games that gamblers play, it all depends on the cultural influences and socio-cultural level of the individuals.

What are your causes?

The causes are multifactorial. There could be a family history of gambling problems. Young people can become involved in dysfunctional learning patterns that draw them into unedifying behaviors.

In fact, among men, gambling usually begins at a young age; appears in young people associated with the consumption of drugs, alcohol and tobacco. The lack of a functional family base precipitates these behaviors.

The human brain tends to seek the shortest path in the pursuit of satisfaction. Gambling bets generate immediate enjoyment, which is why it tends to be one of the most addictive human activities, rather than reading books, studying or engaging in sports.

Furthermore, the mind is seduced by the reward principle . And it is that the physiological principle of addiction is based precisely on the creation and feedback of the reward circuit. The gambler’s satisfaction is due to the exacerbated production of dopamine, the pleasure hormone.

Gambling is also reinforced in people with personality conflicts, eager to create wealth without working and with a tendency to experience strong emotions. The prevalence of mood disorders, caused by unresolved emotional dissatisfaction, such as depression, causes avoidance behaviors.

Borderline Personality Disorder (BPD) has been determined to be in the nature of addictions. Stressful contexts influence the accentuation of gambling problems, since, in principle, they reduce anxiety.

A no less important factor is the lifestyle that is falsely promoted in the advertising media, based on the wealth that comes from making money playing in casinos and other betting houses and digital systems.

What are its consequences? 

The consequences are multiple, it depends largely on the extent to which this condition develops. When it is not treated in time, its psychological, social and economic repercussions could have less negative effects. However, the seriousness it represents lies in how it can permanently harm both the gambler himself and the family as well.

Consequences in the family

The Destruction of human interrelationships : aside from the addict himself, the family and those close to him are forced to move away from the vicious scheme posed by the subject. The family nucleus deteriorates.

Health consequences 

Loss of health : understood as a whole, the gambler gradually loses his health. Dissatisfactions turn into anxiety disorders, depression, and loss of sleep. Eating disorders are added.

Psychological and social consequences 

Educational and Work Failure : Gambling addiction dramatically reduces concentration on really important activities. However, the gambler is regularly unable to imagine the future that awaits him. In practice, the subject may lose any lawful way of earning a living.

By lowering intellectual and cognitive performance , people end up failing in school or missing out on great career opportunities. Unfortunately, in the most serious cases, patients face serious difficulties in regaining their autonomy and independence in various aspects of their personal life.

Treatment 

Family members play a central role in achieving the cure or control of this disorder, since support is essential to encourage the patient to go to a specialist.

For this reason, tackling the problem at an early stage is also essential, before the family is dragged down by the consequences of gambling in the family. Getting the gambler to accept that he is sick is already an uphill task.

The methodology basically follows the same protocol for drug addictions. Of course, the therapeutic and pharmacological actions depend on the severity of each case and the conditions in which the family environment is found, which must surely be incorporated.

Depending on the training of the specialist and the nature and characteristics of the patient, the participation of psychologists and psychiatrists will be more or less relevant and the selection of one or another therapy (systemic, behavioral, cognitive or their combinations, etc.)

The care is regularly outpatient , but there are complicated cases with other pathologies that need hospital care 24 hours a day. In addition, at some stage of the treatment, the patient may join support groups, where their motivation to overcome the addiction to gambling will be reinforced.

Like any addiction, the permanence of sobriety (if the term fits) will ultimately depend on the patient, who at some point will have to resume the routine of his life. Relapses are possible if the basic rule is not respected: do not play again. The longer it takes to request medical and psychological assistance , the longer the treatment time, which can extend up to two years.

Psychiatric medicine is the one empowered for the indication of drugs. Antidepressants and other psychotropic drugs are used to help the patient overcome associated pathologies. In addition,  the prescription of synthetic hormones (serotonin and dopamine), are often used to manage the behavioral responses of the patient.

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Alexa Clark specializes in Cognitive Behavioral Therapy. She has experience in listening and welcoming in Individual Therapy and Couples Therapy. It meets demands such as generalized anxiety, professional, love and family conflicts, stress, depression, sexual dysfunction, grief, and adolescents from 15 years of age. Over the years, She felt the need to conduct the psychotherapy sessions with subtlety since She understands that the psychologist acts as a facilitator of self-understanding and self-acceptance, valuing each person's respect, uniqueness, and acceptance.

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