Although most people who gamble do not have a problem, a small subset of them develop pathological gambling. This condition is characterized by a persistent, recurrent pattern of behavior that significantly interferes with work or family life and causes distress or impairment. Symptoms include a preoccupation with gambling, an inability to stop gambling, and a desire to recover lost money. Pathological gambling is a serious mental health disorder and can be treated with psychotherapy and other behavioral treatments.

Psychiatrists have long debated whether gambling is a true addiction, but more and more research is supporting the idea that some people are indeed addicted to this activity. For example, a survey found that as many as 20 million Americans have a gambling problem. And, as Shirley’s story demonstrates, an addiction to gambling can have tragic consequences.

In the past, the psychiatric community generally considered gambling a form of impulse control disorder, along with kleptomania and pyromania (fire-starting). However, in a move that some experts consider a milestone, the American Psychiatric Association recently moved pathological gambling into the addictions chapter of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Most forms of gambling involve betting something of value on a random event with the intent to win money or other goods or services. Examples of gambling activities include horse racing, lotteries, sports wagering, and casino games. Some people may even place wagers on video games, such as poker or blackjack, which can be played with real money or virtual currency.

Gambling is usually accompanied by the feeling of excitement, which is partly a result of the brain release of dopamine, a neurotransmitter that makes you feel good when you win and bad when you lose. Some people develop a habit of gambling when they are stressed, depressed or anxious, making them more likely to be affected by the urges to gamble.

While there are no medications approved by the FDA to treat a gambling disorder, some drugs can help treat co-occurring conditions like depression and anxiety. In addition, counseling can teach a person how to recognize and cope with the triggers of a gambling urge, as well as how to solve problems related to their gambling habits.

Some therapists use cognitive-behavioral therapy, which teaches patients to change unhealthy gambling behaviors and thoughts, such as irrational beliefs about the odds of winning. Other therapists employ family therapy, which can help people with gambling disorders discuss their problems and work together to create a stable home environment. Finally, some therapists use psychodynamic therapy, which focuses on unconscious processes that influence one’s behavior. Those suffering from gambling disorder can also find support from peers in self-help groups, such as Gamblers Anonymous. Lastly, physical activity can also help reduce the urge to gamble by decreasing stress and anxiety. And, of course, a national helpline and other resources are available for those who need them.