Diagnosing Gambling Addiction – or Not 

A gambling addiction can’t be diagnosed by taking a blood test or a scan. Most patients may show signs of depression, but unless they are open about it, there is no way the doctor will know the reason why. There is no physical evidence that someone’s depression is due to an uncontrollable urge to gamble and the family and financial problems that such addiction has created. If the stigma alone wasn’t enough to make it difficult, in countries where gambling is illegal, addicts will be even less likely to admit they have a problem. More often than not, the diagnosis is “depression” which, although true – gambling addicts often suffer from depression – is also incomplete, as the root causes remain unidentified.

One study from the US National Institutes of Health showed that 76% of gamblers surveyed also suffered from depression. The suicide rate among self-identified gamblers is four times higher than among non-gamblers. This may lead to a confusion of correlation and causation, and contributing to a gambling addiction misdiagnosis, or incomplete diagnosis. We need to ask “which comes first: the clinical diagnosis, or the gambling behaviour?”

Correlation Vs. Causation

For some people, an addiction to gambling may be a product of depression or another underlying condition. For most though, that depression is a result of their gambling addiction. The stress of losing money, plus the strain this puts on the victims’ personal lives, on their families, on their jobs, create the ideal circumstances for depression and other mental health issues to flourish. This isn’t unique to gambling addiction. In fact, many individuals with behavioural addictions are misdiagnosed with problems like obsessive compulsive disorder. It can happen with any number of addictions, but there are unique factors at play with compulsive  gambling , though, such as inconsistent social acceptability or legal status, that makes it especially tricky to identify as the cause of suffering.

When Gambling is Illegal

Making something illegal, doesn’t necessarily mean it will be easier to deal with. Some scholarly evidence suggests drug prohibition for example, does little to actually reduce drug addiction, and may even make addiction worse. The reason is simple – while it may help authorities act against those who “operate the market”, the illegal status also acts as a barrier between the victims and the treatment. The US is a good example of this dilemma: although gambling is only legal in a select number of states, the rate of gambling addiction is higher there compared to the UK.

The problem of recognising an addiction to gambling is complicated by the rise of online betting. In countries or regions where betting is illegal, health professionals may be less inclined to consider gambling behaviour when looking at a patient. Gambling Disorder was included in the latest edition of the DSM in 2014, but it’s still a recent change. If the patient is uncomfortable with disclosing their gambling habits – because it is an illegal activity, and/or because the insurance policy wouldn’t cover it – the job of the doctor or therapist becomes a lot more difficult.

The Problem is The Gambling

Gambling addiction is rarely a self-evident issue. Here are a few common signs that something is wrong:

• Remorse: Those with an addiction typically aren’t having fun when satisfying their urge. It’s a compulsion, not a leisure activity, and feelings of remorse are a common side-effect.
• Need: Addicted individuals often see gambling as a way to resolve other problems like debts, or even to recover previous betting losses. They feel the need to keep playing to try and solve these issues.
• Mismatch of Priorities: Because gambling is a compulsion, it feels natural to place it higher on a list of priorities than is appropriate. It can overshadow family and friends, work, and paying bills.
• Sense of Inevitability: Some problem gamblers see their habit as an inevitable part of life, about which nothing can be done. The problem may rise to the point that “gambling money” becomes a regular monthly expense, and often one that takes priority, as mentioned above.
• Inability to Stop: Problem gamblers may keep placing bets until all their money is gone. Gambling may also take up large shares of their time, as they have absolute confidence they are working on getting their money back.
• Compulsive Response: Problem gamblers don’t just gamble when the mood strikes them. Like any addict, they feel compelled to place a bet. It can be an all-encompassing urge that overrides other interests or responsibilities.
• Escapism: Betting is a means of escape for many addicts. As a result, sources of stress, arguments, or everyday disappointments and frustrations can trigger the urge to gamble.

Early identification is essential for effective treatment of gambling addiction. However, that will require society as a whole to see beyond the shame, challenging our own experiences, and staying away from prejudice. That will help those with the problem to open up about it, and it will help those with the treatment resources to use them without reservations. Ultimately, it will drive the growth of those resources, backed by statistics that truly reflect the reality.

Helping Gamblers Help Themselves

Gambling addiction is highly stigmatised. It’s seen as a personal failure or weakness, rather than a real condition which demands treatment. We need to stop this and foster an environment in which people can speak honestly about their problem. For example, we can start by dispelling many of the myths about gambling addiction:

• Addiction only happens to certain groups of people.
• You have to gamble every day to be addicted.
• It's due to personal weakness and irresponsibility.
• Problem gamblers are motivated solely by the allure of money.
• Problem gambling only affects the gambler.
• These are all misconceptions. Every single one of them.
• An addiction to gambling can happen to anyone, anywhere, at any point in time.

People can feel more comfortable seeking help once we all have a more honest conversation about problem gambling. Until that happens though, gambling addiction misdiagnosis will continue to damage people’s chance of recovery.

Worried that you, or someone you know, might be suffering from an addiction to gambling? The first step to deal with it is to put as many obstacles as possible between the player and the game:

• Gamban blocks access to 40k+ gambling websites. It blocks the device itself from accessing those sites and is available for computers, phones and tablets and stop gambling. Click here to get started.
• For those in the UK, we also recommend signing up to GamStop. This voluntary scheme self-excludes players from a large number of UK based gambling websites, in one go.
• Gamcare offers The National Gambling HelpLine, providing confidential information, advice and support for anyone affected by problem gambling in the UK. - 0808 8020 133
• Another important roadblock is money. Monzo and Starling banks have developed features that block gambling related transactions. We recommend taking a look at those.
• There are a number of self-exclusion schemes out there, as well as support groups.