Seldom does gambling addiction stand alone as its own destructive habit. More often than not, there’s also another underlying issue that’s responsible for driving your urge to place bets, no matter the toll it’s taking on your relationships, career or finances. “To treat gambling addiction,” says Timothy Fong, MD, co-director of the UCLA Gambling Studies Program, “you also have to treat the psychological issues it comes with.” Otherwise, “it’s like the gas and brake pedals in your car,” he says. “If they’re both broken and you fix just one, your car still won’t work.”
So if you have a gambling problem, be aware that these five disorders often go hand-in-hand with compulsive gambling; to get better, you will need help with any you’re struggling with now:
Against the backdrop of a high-energy race track or flashy casino it can be easy to miss the fact that gamblers are likely to suffer with depression and other serious mood-related problems. “A psychiatric disorder is the norm in gambling addiction,” says Dr. Fong. “And the number-one problem we see is depression.” In fact, a study in the Canadian Journal of Psychiatry found that people with either major depressive disorder or bipolar disorder were four times more likely to have a gambling problem than the general population. The study also found that in 71% of cases the mood disorder came first, so before the gambling addiction set in.
To get a sense of the magnitude of the problem, a new study in the journal Psychiatry Research found that problem gamblers with a mood disorder like depression or bipolar disorder were five times more likely either to attempt suicide or to develop suicidal thoughts. Female gamblers had an even greater likelihood of entertaining suicidal thoughts, according to the study. Determining the direct cause of suicide — either gambling or a preceding affective disorder — is nearly impossible, says Anja Bischof, lead author of the study and a psychiatrist at the University of Lüebeck, in Germany. As treatment for suicidal gamblers, she suggests inpatient treatment — the same recommendation she has for any depressive disorder with suicidal elements.
Unfortunately, many gamblers say they’ve never felt so alive as when they’re immersed in the act of gambling, according to Dr. Fong. That rush quickly fades, though, when the negative outcomes set in after a gambling spree. “The consequences of gambling are steep debts and abject poverty,” he says. “That’s miserable and keeps somebody in a depressive state.”
2. Drug and Alcohol Addiction
Gambling addiction frequently couples with a substance addiction. While the research doesn’t make clear which typically comes first, the two are undeniably linked. In one recent study in the Journal of Clinical Psychiatry, 68% of pathological gamblers had a substance abuse problem – about three times more than the control group. “The high rates of substance abuse with pathological gambling speak to the link between the disorders,” says Donald Black, MD, a psychiatrist at the University of Iowa and lead author of the study. “The behavior and the psychology of gambling addiction suggest that the underlying neurobiology is related to alcohol and drug addiction, which is why you find them together.” Research backs up Dr. Black’s assertion: Brain scans of pathological gamblers show deficits in the brain’s reward and pleasure centers similar to the effects of drug use, according to a study in Molecular Psychiatry.
3. Antisocial and Borderline Personality Disorders
Gamblers tend to be loners. That partly explains the high rates of divorce and low rates of happy marriages among pathological gamblers. But the antisocial behavior that gamblers frequently experience is a serious problem. The largest study to examine the relationship between personality disorders and pathological gambling found that gamblers were over six times likelier to have a life-long diagnosis of antisocial personality disorder.
Dr. Black’s research in a five-year study concluded that antisocial and borderline personality disorders are two of the most frequent ailments to accompany gambling addiction. In fact, he found that antisocial personality disorder is also found in the relatives of pathological gamblers more frequently than any other disorder. “These disorders are characteristic of impulsivity and bad decisions. That’s why you also see these disorders, and problem gambling, associated with crime and risk-taking,” he says. “The fact that it runs through families suggests there’s a genetic component or a shared neurochemistry increasing the risk for gambling addiction.”
4. Hormonal Imbalances
The hormone cortisol regulates stress levels, reward-seeking and several other aspects of behavior. Most people have a strong cortisol reaction to erotic stimulation, but that’s not the case for gamblers. They seem to have less sexual arousal and more interest in fast money. Researchers tested out monetary and erotic stimulation on gamblers and control subjects (those who didn’t gamble). It turns out the brain of the addicted gambler releases much more cortisol for monetary rewards, according to the study in Frontiers in Behavioral Neuroscience. The findings suggest that cortisol plays an instrumental role in gambling addiction, and the hormone encourages the brain to seek pleasure from gambling. Perhaps inducing cortisol release from healthier habits, like exercise, might build a healthier connection, suggests Fong.
5. Weight Issues
Whether it’s the food served at the track or the sedentary hobby of pumping quarters into a slot machine, compulsive gamblers tend to have worse physical health than the general population. “You typically see a high body-mass index, poor cardiovascular health and [an elevated] risk for diabetes and stroke in a population of gamblers,” says Fong.
But weight-related health problems aren’t the only issue. As a gambler gains weight, the gambling problem itself balloons. In one study, the poor physical health of overweight gamblers correlated with an increase in substance abuse and destructive bets. Obese gamblers were shown to consume more nicotine and lose more money per week.
Clearly, a gambling habit can affect not only your finances, but also your physical and mental health. Pay attention to the symptoms that accompany a gambling addiction to help put the brakes on all the ways this problem can affect your life or that of someone you love. Gambling is often a furtive disorder and can be easily hidden; that means adverse consequences may go undetected, says Dr. Bischof. Instead, if problem gambling is affecting you, do your best to turn to positive activities, like exercising, socializing and spending time with family and friends, instead. And talk to a therapist for help with both the gambling disorder and any other mental health issues you may be dealing with, suggests UCLA’s Fong.