Gambling is a form of entertainment where the participants risk something of value on an event with an uncertain outcome. The event is usually a game of chance, or a contest in which skill can be applied to influence the result. There are several categories of gambling, including lotteries, races, and games of skill. Gambling may be legal or illegal, depending on the jurisdiction. In general, the more money involved in a gamble, the higher the stakes. It is possible to lose more than the amount wagered, and gambling can be addictive. In addition, the behavior can cause damage to relationships and careers, lead to financial difficulty, and even suicide.

Some people are at higher risk for gambling problems than others. A person’s genes, as well as traumatic experiences and social inequalities, are important risk factors. A person can develop a problem with gambling at any age, but symptoms usually begin in adolescence. They can continue throughout a person’s life and be exacerbated by other factors, such as depression, anxiety, alcohol and drug abuse, or marital conflict.

Understanding Pathological Gambling

Our understanding of gambling and its risks has changed significantly in the past few decades. Historically, it was believed that pathological gambling is a mental illness and that those who have problems with gambling are unable to control their behavior. This belief was reflected in the diagnostic criteria for gambling disorder in the various editions of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association (DSM).

In the DSM-5, the behavioral diagnosis of pathological gambling is defined by the presence of 10 criteria: (1) damage or disruption to personal, occupational, or social affairs; (2) loss of control over gambling behavior; (3) preoccupation with gambling; (4) lying to family members, therapists, or other persons in order to conceal the extent of involvement in gambling; (5) a pattern of recklessness or risk-taking; (6) feeling distressed when not engaged in gambling (e.g., helpless, guilty, anxious, or depressed); (7) after losing money in gambling, returns another day to try to get even (“chasing” losses); and (8) has jeopardized or lost a significant relationship, job, educational or career opportunity, or resorted to illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling. The DSM-5 also includes a partial exclusion criterion: that the gambling behavior is not better accounted for by a manic episode.

While a person who has a problem with gambling can seek treatment, it is often difficult to quit the habit. Counseling can help people understand their problem, think about alternatives, and make changes. Therapy can also help address mood disorders that may be triggered or made worse by gambling, such as depression and anxiety. Medications are rarely used to treat pathological gambling, but they can be helpful in treating co-occurring conditions like depression and anxiety. The most important step in recovery is to find other ways to relieve unpleasant feelings and avoid engaging in compulsive behaviors, such as exercising, spending time with friends who don’t gamble, or practicing relaxation techniques.