Unmasking Gambling Addiction in Men: Recognising the Signs and Seeking Help
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Whilst most people start gambling to experience the buzz and thrill that comes from the anticipation of a big win, a subset will go on to develop an addiction to gambling; a serious mental health condition that affects about 0.4% of the population (Gambling commission 2021).
Men are far more likely than women to develop an addiction to gambling than are women – UK data suggests that 4.4% of men and 1.1% of women engage in at-risk or problem gambling behaviours. This is due to a number of factors – including personality characteristics like competitiveness, high risk appetite, impulsivity and a proneness towards avoidant coping. Furthermore, the exposure to gambling through advertising has classically targeted men, although this profile appears to be changing somewhat in recent years3.
Gambling addiction; signs, symptoms and consequences
Gambling addiction causes widespread damage. The emotional stress and anxiety experienced by an addicted gambler during an episode must not be underestimated. As the losses mount, the competitiveness and the drive to restore the account balance frequently speed up the gambling activities and adds further intensity and despair with more inevitable reoccurring losses. The shame, guilt and desperation that grows as losses mount are difficult for the gambler to bear, but also sadly also gives more force to the fast-moving spirals that gamblers facing addiction get themselves stuck in.
Once control is lost, they will continue to gamble in response to losses as well as wins. As can be understood, this creates a situation that no longer has any possibility of sustained winnings. The financial losses and the devastating impact this has on the gambler themselves, their family, as well as on any other people/places involved in bail outs and/or lending money can be extreme. As with any addiction, lies and concealment are typically part of the output that results from the compulsive drive to keep gambling at whatever cost – financial or emotional.
Denial and inner conflict are ever-present in gambling addiction. One of the toughest aspects behavioural addictions tends to be the inability of people surrounding the gambler to fully understand that denial is part of the addiction itself – and not a sign that their loved one has turned ‘evil’ or is deliberately choosing to lie about their activities or their willingness to stop.
Understanding gambling addiction
The pathways to gambling addiction can vary tremendously4. Some men seek out gambling as a way of escaping difficult emotions, while others are chasing a ‘rush’ that gets increasingly hard to achieve. And, just like in substance addictions, the increase in tolerance is a core symptom of gambling addiction.
Tolerance in gambling manifests itself as increasing stakes, taking more risks, and often in a broadening of gambling related activities and the time dedicated towards it. As the preoccupation with gambling gets stronger, this also has the undesired effect of lessening pleasure experienced form ordinary life experiences. This can then cause intense distress for gamblers who are finding themselves appearing to ‘choose’ gambling over their more heartfelt priorities. As someone that has worked extensively with both behavioural addictions and substance addictions, I find that gamblers can be particularly cruel to themselves as they find it unbelievable that they are not able to control their cravings and resist gambling despite the absence of a substance.
For those around the gambler, this is perhaps one of the features that creates the most anger, disappointment and hurt. It is immensely difficult for loved ones understand how ‘hijacking’ the effects of behavioural addiction can be on the brain. It is also hard for them to accept that, whilst still hurtful, the person is not anymore intentional in their continued seeking out of the addictive behaviour than those who are addicted to substances like drugs or alcohol – despite being seemingly ‘sober’ whilst they are engaging with their unhelpful behaviours.
Cutting losses and choosing to overcome gambling addiction As gambling addiction becomes more severe, the utility of the gambling activity typically broadens. It is not unusual for treatment seeking gamblers to use the activity as an emotional crutch; a form of escapism, and also as deluded form of hope that the gambling itself will somehow offer up the solution to the gambling problem. And it is the idea of resorting to more gambling as a way of ending the addiction that sets gambling aside from other addictions. Whilst the increase in tolerance and preoccupation has direct parallels with substance addictions, the speed with which people can dig a deeper hole while believing they are helping themselves (and sometimes others) tends to be fairly unique to gamblers.
The conviction that a win will ultimately come in can drive people to take risks they would not initially have dreamt off. Situations where this chase has been going on in secret and the gambler is faced with the increasing realisation that things will not work out, can sadly lead to extreme distress; the stigma, isolation and deep shame felt by the gambler can create a sense of hopelessness and desperation. This is the reason for the sobering fact that those living with a gambling addiction exhibit one of the highest suicide rates of all mental health disorders.
This is why seeking professional help promptly is extremely important!
Gambling addiction: overcoming the hurdles to access help
As with any form of denial, the gambler may believe that their issue is not one of addiction and instead views their problem through a lens of financial deficit. By doing so, the losses and any financial debt frequently acts as a major trigger for continued engagement.
A critically important first step for any addicted gambler is the acceptance of the fact that gambling has been responsible for creating a whole host of emotional, relational and financial problems – and can therefore not be used as a way of resolving such difficulties. The only way to progress forwards is to stop the gambling and start to tackle what lies underneath.
Another common hurdle that stops gamblers from seeking help is the faulty believe that they are ‘weak’ or ‘bad’ for not being able to conquer their urge to gamble without assistance. Whilst they might recognise that they are suffering from an addiction, they simultaneously find it difficult to accept that the loss of control is at the very core of their addiction. From a treatment perspective, this is a problem that leads to resistance often far beyond the point of seeking professional help.
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Since the outward signs of gambling are often vague and can be explained by a multitude of other factors, it is notoriously hard for people around the gambler to pinpoint the exact nature of the problem. Family and friends may suspect that something is wrong, yet be unable to fully understand the confusing pattern of low mood, anger, anxiety and occasional periods of elation. The hidden nature of gambling addiction means that it can progress ‘silently’ to a very severe level before intervention happens.
DSM 5 diagnostic criteria for Gambling addiction
According to the DSM-5, a diagnosis of gambling addiction requires that a person exhibits or experiences at least four of the following symptoms within a 12-month period:
Understanding these symptoms is crucial for recognizing gambling addiction and seeking appropriate treatment.
Help is out there!
Thankfully, there are an increasing number of avenues to get help for gambling addiction.
Depending on the severity of the gambling and a range of other factors the treatment can take many different forms. In the most severe cases, inpatient rehabilitation may be necessary as a way of achieving a complete cessation of the gambling and a psychological break from triggers. But for the majority, inpatient treatment is not necessary. In such situations, Cognitive Behaviour therapy has consistently achieved the strongest evidence base amongst the various forms of treatments available for problem gamblers5. Individual or structured CBT group therapy is often paired with other forms of support – such as Gamblers anonymous and family interventions – to achieve the most long-lasting impact. Treatment frequently involves a heavy component of psycho-education and may also feature advise around financial management.
Breaking the isolation of an addiction is a very critical step and one that dramatically reduces the feelings of loneliness and hopelessness often felt.
It can be difficult in a moment of desperation to appreciate how differently things will feel after drawing a line under the gambling. As a treatment professional, I always emphasise the importance of being willing to take a leap of faith and trusting that with dedication and support, things will gradually change and improve – much as it does not feel like they can.
Treatment for gambling involves ways of achieving a complete stop to the gambling activity, first and foremost. But it also incorporates dealing with what lies underneath the surface. Depending on each individual’s circumstances, this may include attention to emotion regulation, long-term underlying mental health conditions and/or neurodivergent diagnosis. Treatment must also help the gambler better understand the triggers for their addictive patterns and learn new skills and tools for identifying and dealing effectively with these. Most people will then need to consider healthy ways of enriching their lives in areas where the gambling has been allowed to take over.
It can be tough for gamblers to appreciate the financial value of investing in treatment at a time when huge losses have been incurred and for some it simply is not an option to pay for treatment. Thankfully, there are several options available in the UK. A key first step is to start researching such options and trying to identify the ones that best matches the budget and the needs of the client.
References
3. Understanding how consumers engaged with gambling advertising in 2020 (gamblingcommission.gov.uk)