Casinos, sporting events, lotteries, Internet gaming... Opportunities to gamble are everywhere. But what do you do when the gambling gets out of control?

Dog races, card games, slot machines, dice, sporting events, lotteries, Internet gaming, bingo, the stock market...

Gambling has become increasingly persuasive in our society and widely endorsed as a fun and exciting form of entertainment. But for some people, it has serious social, financial, interpersonal, and emotional costs—and can even lead to significant health problems.

Alex never thought he would find himself in a Gamblers Anonymous meeting, tearfully discussing the tragic circumstances of his present life. In the past six months, the handsome 44-year-old had lost his job, his marriage, his two young children, and some good friends. He developed high blood pressure and stomach problems, and started having thoughts of suicide. Lost in a whirlwind of wagering, financial bailouts, lies, and family and job disruption, Alex watched his world crumble as his gambling spun out of control.

Gambling is betting or wagering for personal benefit or the benefit of others. It depends on chance or skill and may or may not involve money. Most people who participate in gaming activity are social gamblers who gamble for fun, without harmful effects. Some people, however, cannot control their impulses to gamble, despite negative consequences. They are compulsive gamblers.

Characteristics of Compulsive Gamblers

The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-IV), characterizes pathological gambling as consisting of five or more of the following behaviors:

* Preoccupation with gambling
* Spending increasing amounts of money on gambling in order to achieve desired excitement
* Repeatedly trying to control, cut back, or stop gambling without success
* Restlessness and irritability in response to attempts to cut down or stop gambling
* Gambling to escape problems, feelings of helplessness, guilt, anxiety, or depression
* Returning to get even, after losing money gambling (chasing losses)
* Lying to family members and others to conceal the extent of gambling activity
* Committing acts of forgery, fraud, theft, or embezzlement to finance gambling
* Jeopardizing a significant relationship, job, career, or educational opportunity due to gambling
* Relying on others for money to relieve serious financial problems caused by gambling

Many compulsive gamblers suffer from other addictive disorders, such as alcohol and substance abuse. Mood disorders, such as depression, are also common.

Compulsive gamblers may be male or female; young, middle-aged, or old; wealthy or poor; and from a variety of racial and ethnic backgrounds. Studies suggest that between 9% and 14% of youth can be classified as at risk for a gambling problem. According to the National Council on Problem Gambling, 4% to 7% of young people already exhibit characteristics of pathological gambling.

Consequences

The consequences of compulsive gambling may include:

* Large financial debts
* Marital problems
* Loss of employment
* Poor performance in school and/or dropping out of school
* Isolation from family and friends
* Legal problems
* Physical and emotional problems
* Suicide or suicide attempts

Causes

Compulsive gambling often runs in families. Compulsive gamblers and their closely related family members also tend to have very high rates of alcoholism, major depression, and bipolar disorder. Like these other diseases, compulsive gambling is thought to occur more commonly in individuals who have abnormal levels and abnormal functioning of the neurotransmitters called dopamine and serotonin. Studies of compulsive gamblers have shown that, in fact, they do have abnormal both levels and abnormal functioning of these neurotransmitters. Imaging studies (PET scans) of the brains of compulsive gamblers have also shown that there are differences in their brain structure/function.

Getting Help

Treatment is often started when compulsive gambling leads to legal or personal problems, or when family members confront the gambler. Treatment requires stopping all forms of gambling and may include attending a self-help group, such as Gamblers Anonymous, and/or psychological counseling. Treatment of associated conditions, such as alcoholism and mood disorders, may also be beneficial. There is evidence that the antidepressant fluoxetine (Prozac) may help some people abstain from gambling during treatment.

Helping a Loved One Who Has a Gambling Problem

It can be difficult to confront a loved one about his or her gambling problem. A certified compulsive gambling counselor may help you plan the confrontation. Your loved one will need the assistance of a therapist, health care professional, or self-help group such as Gamblers Anonymous. You also may need professional help for yourself. GamAnon is a self-help group for people whose lives are affected by a compulsive gambler. The group can help you work through the losses, anger and pain that have resulted from your loved one's gambling problem.

The Arizona Council on Compulsive Gambling suggests the following four steps when confronting a loved one about problem gambling:

1 - Validation (showing care and concern)

* Let your loved one know that you care. Focus on his or her positive attributes ("I care about you because...").
* Remind your loved one that there is more to him or her than the gambling problem.

2 - Documentation (describing the behaviors that concern you)

Using "I" statements ("I see," "I felt hurt when you...," "I'm willing to listen."), describe in detail the behavior you find unacceptable (bounced checks, credit card bills, or missed holidays) and how it has affected you. Although your feelings may be strong, try to be calm and nonjudgmental.

3 - Recommendations (what you want your loved one to do)

You may want to ask your loved one to:

* Answer the 20 Questions of Gamblers Anonymous
* Attend Gamblers Anonymous meetings (x number of meetings per week)
* Develop a plan to manage money as you recover from financial setbacks
* Demonstrate that he or she has been consistent in changing problem behaviors for x period of time before you make major relationship decisions
* Seek counseling from a certified compulsive gambling counselor
* Attend outpatient group sessions for gamblers
* Use inpatient treatment when appropriate and available

5 - Consequences

Think about what is likely to happen if your loved one does or does not follow your recommendations. Present only the consequences you are willing to live with and act on.

Despite all the loss he suffered, Alex was on the right track by joining Gamblers Anonymous. If you recognize the signs of a gambling problem in yourself or a loved one, know that there is help to get on the right track.

RESOURCES:

Gamblers Anonymous
http://www.gamblersanonymous.org