Five important facts most people miss Gambling Disorder edition  

Gambling disorder is invisible  

Gambling disorder is the invisible addiction. Counselors cannot test for it, doctors can’t find it in a lab. Patients with gambling disorder can go years without help, without care, and without understanding that they are headed towards disaster. That’s what makes gambling patients so special. These individuals have fought through a constant barrage of messaging, advertising, and cravings just to get into treatment. Most of them are not forced to be in treatment, they want to be here. Once in treatment, patients can learn to identify the hidden signs of their disease. It’s not so scary anymore. Because gambling disorder is hidden initially, it also presents with symptoms like suicidal ideations and thoughts, depression, anxiety, family conflict, and denial. 

On average, it takes patients 10 years to get help 

Patients with a gambling disorder often wait years to get help, living off of denial and despair as their gambling disorder progresses. Patients who seek care early on tend to avoid some of the more severe consequences like embezzlement. However, it’s never too late to get treatment. The longer a gambling disorder progresses without help, the more the brain starts to play tricks to get the patient to keep gambling.  For example, some patients experience high levels of irritation when coming down from a gambling high. This irritation (referred to as PAWS) is part of the brain’s response to a lack of dopamine. The brain is essentially sending signals to the gambler that he or she MUST gamble again soon, or face misery. Families who experience these mood swings often don’t know what to do to help their loved ones. 

Most people don’t even realize gambling can lead to an addiction 

Just because it’s legal, doesn’t mean it is safe. Now that gambling is legal in some form in all 50 states, and casinos are starting to pop up almost everywhere, the availability of gambling increases the amount of people who may develop a gambling disorder. Also, some individuals already recovering from a different addiction may turn to gambling not realizing the damage they may be doing to their recovery. Diagnosing a gambling disorder means exploring the potential patient’s preoccupation with gambling, need to gamble with increased amounts of money, unsuccessful attempts to stop or control gambling, restlessness or irritability when trying to control gambling, chasing losses, lying or hiding evidence of gambling, gambling despite consequences, and financial bailouts. 



It’s still being studied 

Most people don’t realize the infancy of the research around gambling disorder as an addiction. Just 13 years ago, in 2013, gambling disorder was finally moved from the classification as an impulse control disorder to the classification as a substance use disorder. Currently, gambling is considered a substance and is thought to impact the brain in the same way alcohol might. However, it wasn’t until 1980 that gambling disorder was even classified as a psychiatric problem with clinicians focusing on loss of control, chasing losses, and negative consequences. In 1994 with the publication of the DSM IV, criteria to diagnose gambling disorder became more standardized. However, it wasn’t until 2019 that the World Health Organization listed Gambling Disorder under “Disorders due to addictive behaviors.” 

There are some medications which may make gambling disorder worse  

There are some medications prescribed for various related and unrelated issues that have been shown to amplify a patient’s impulsive urges and contribute to the proliferation of a gambling disorder. Abilify is one such medication. Abilify is a dopamine D2 partial agonist, used to treat Schizophrenia, Bipolar disorder, and Depression. Abilify increases the patient’s reward sensitivity while also increasing their impulsive decision making. The medication may also impact the decision making area of the brain called the pre-frontal cortex. Other medications shown to impact gambling include Pramipexole, Ropinirole, and Rotigotine.