Understanding Gambling Addiction

I was reviewing some of the material on the old website (www.gamharm.com) and thought that the section on the impact on Health and Wellbeing of living with Gambling Addiction was still quite useful as a primer on the subject, and worth re-iterating here. Especially as an aid to explaining the mindset and behaviours of someone who is suffering from Gambling Disorder to someone who isn't.

So, if you know someone whom you think might have a gambling addiction then this might be worth a read.

HEALTH AND WELLBEING

Another primary harm that can, and usually does, accompany full blown Gambling Disorder is a negative impact on the health of the affected individual, in terms of both physical and mental wellbeing.

Individuals in the grip of a gambling disorders invariably feel a heightened state of guilt, and a lowered state of self-esteem. It is also common for them to experience prolonged and persistent sleep deprivation. An addicted gambler's compulsion to extend sessions of gambling for as long as they are physically able to, combined with post session restlessness due to heightened brain activity and nagging guilt and remorse over losing money and betraying the trust of loved ones, all act together to impact the individual's ability to sleep well. Sleep is the body's repair and reset function, and lack of sufficient sleep leads to increased metabolic stress, impaired cognitive ability, and a general feeling of listlessness and malaise, none of which is good for the long term health of the person involved.

In the initial stages of a Gambling Disorder, many individuals will feel extremes of emotion depending on the outcomes of their gambling, and the significance of what the money lost or won could mean for their financial positions - for instance, winning enough to pay the next big bill could bring intensified elation, especially if they were likely not to be otherwise able to pay that bill due to monies previously wagered and lost (a.k.a. getting out of the hole). The converse scenario would be the deep despair coming from realising that as a result of a gamble not paying off they may not be able to cover their living expenses, or to buy that present which they had promised their child. A negative reaction that is only enhanced by the knowledge that without having gambled at all it would not have become an issue in the first place (a.k.a. digging the hole). Although we as humans can take enjoyment from adrenaline fueled highs, the extreme contrasts between gambling related highs and lows is not a healthy situation to be enduring over prolonged periods.

As a Gambling Disorder develops, the extreme highs of winning become muted, as indeed do the extreme lows of losing. While this might on the face of it sound a good thing, given what we just said about the rollercoaster of gambling emotions being bad in general for our mental welfare, the truth is that this phase of addiction is not at all a welcome change but instead indicates a further deterioration in our mental balance. The disordered brain has entered a phase where the person's emotional response has become detached from the results of risk/reward based actions. Often, when this occurs, the concept of winning or losing is no longer the primary trigger for reactive emotional outcome and it becomes the act of creating risk which primarily triggers the brain's reward centre. The possibility of gaining from engaging in gambling may still present itself as an internalised rationalisation for continuing to gamble, but in reality this is self-delusion as the brain releases more endorphins for engaging in the process of enhanced risk taking than it does as a consequence of any given outcome. The addiction has stopped being about winning or losing and is now purely about risking more than one can realistically afford to lose. And in such situations losing is what will invariably happen as winning does not provide the same emotional reward as risking losing does, and so only creates the opportunity to try losing again. 

The reason why disordered gamblers keep losing is that winning is no longer the primary reason for taking part in gambling - even if the addicted part of the brain tries its hardest to suggest otherwise. In some ways a gambling addiction can be compared to a virus - for both the imperative is that they continue to survive and grow. For the virus this usually means finding new hosts to colonise, for the addiction it means finding ways of persuading the sole host to keep feeding it, to keep gambling.

That is not to say that losing brings much joy. It doesn't, but one of the few moments of peace which are afforded an addicted gambler often occurs directly after they have gambled all available funds away - with no money left to gamble the pressure of feeling the need to gamble can temporarily be assuaged - and a small window of clarity is afforded the brain. But alas, not for long. By this stage of the addiction the Disordered Gambler is invariably so guilt-consumed that they almost feel the need to punish themselves and, as such, losing becomes a masochistic realisation of self-inflicted approbation which is accompanied by a continual need to find new funds with which to gamble again. 

Once in this cycle, Disordered Gamblers will rarely stop until they encounter their own 'rock bottom' moment of self-realisation. Unfortunately, this will often only be once they have literally gambled away everything that they can find, legally or otherwise, to use as collateral, meaning that they have effectively impoverished themselves to such an extent that life can seem very unappealing and pointless. Or as a result of some other unavoidable life event overtaking them - such as illness, bereavement, unemployment, homelessness, or even the true extent of their gambling being uncovered by a partner or employer. Such an enforced period of desistance from gambling can temporarily create conditions which allow the gambler to finally take action to address their addiction - a breathing space free from addictive compulsion - and thus spur them on to reach out for help.

It is estimated that only 3% of gamblers engaging in harmful levels of gambling ever do reach out for support and it would be our contention that most of these will have done so only as a result of encountering their own crisis point and enforced abstention from gambling. While ever it is still possible to gamble, the detachment from reality which gambling engenders in the mind of the addicted and disordered person will always act to suppress rational arguments for stopping.

Nor will everyone finding themselves unable to gamble find the motivation and decisiveness to reach out for help - in truth very few will do so. The window of reflection which may finally bring clarity over the harmful nature of gambling, and the inevitability of losing in the long run, can also bring unwelcome focus on the accumulated harm already caused, and without the daily escape which gambling brought, the guilt already present can quickly snowball and lead in turn to deep despair and a sense of utter helplessness. At this stage, and without intervention from loved ones and professionals, it can lead to long term depression and suicidal ideation. It is estimated that between 4 and 11 percent of annual suicides are related to gambling (equivalent to between 250 and 650 deaths per annum in the UK). Research from Sweden suggests that gambling addicts are 15 times more likely to take their own lines than otherwise would be the case.

For further information, and help on overcoming and preventing gambling related suicides, we would suggest checking out Gambling With Lives, a UK charity formed by surviving relatives of gamblers who committed suicide and who have a wealth of experience and knowledge to share on this extremely important issue.