Additionally, individuals with a pathological gambling disorder have a high rate of co-morbidity rate for additional mental health disorders (depression, bipolar disorder, anxiety, personality disorders, and other impulse control disorders) and substance abuse. In fact, a major depressive disorder is likely to occur in ¾ of all pathologic gamblers.
Diagnostic Criteria for Pathologic Gambling
To meet the American Psychiatric Association's PA's diagnostic criteria for compulsive gambling, a person must show persistent gambling behavior as indicated by at least five of the following criteria. If an individual meets 1-4 criteria they are considered problematic gamblers.
- Being preoccupied with gambling (for example, reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
- Needing to gamble with increasing amounts of money to achieve desired excitement.
- Having repeated unsuccessful efforts to cut back or stop gambling.
- Being restless or irritable when attempting to cut down or stop gambling
- Gambling as a way to escape problems or to relieve a dysphoric mood (feelings of helplessness, guilt, anxiety, depression).
- After losing money gambling, often returning another day to get even ("chasing" one's losses).
- Lying to family members, therapists or others to conceal extent of involvement with gambling.
- Having committed illegal acts, such as forgery, fraud, theft or embezzlement, to finance gambling.
- Having jeopardized or lost an important relationship, job, or educational or career opportunity because of gambling.
- Relying on others to provide money to relieve a desperate financial situation caused by gambling.
Becoming a Compulsive Gambler
Compulsive gamblers fall in love with the excitement and action of gambling. Four phases of compulsive gambling have been identified; winning, losing, desperation, and hopelessness. At first, during the winning phase, the gambler is often successful. This success leads to fantasies of further successes; and resultant wealth, power, and prestige. They are certain they know how to beat the system. Their self-esteem becomes centered on being smarter or luckier than the average gambler.
Inevitably the compulsive gambler suffers financial losses which eventually lead to a damaged ego. In an effort to maintain their self-esteem they begin to rationalize losses and may blame others. During the losing phase the pathologic gambler becomes more preoccupied with gambling. He begins to gamble alone, borrow money, skip work, lie to family and friends, and default on debts. This is the point in which pathologic gamblers begin to "chase" their losses; gambling in order to win back money that was lost, "I'll get even tomorrow." This chasing behavior is a defining characteristic of the pathological gambler. Thus, a vicious cycle has begun; chasing leads to more gambling and additional financial losses. The gambler attempts to determine his handicapping abilities to assure that losses will be minimized. If the gambler has run out of money for "the chase", he now begins to tap into savings or to borrow money. The more money that is spent or borrowed is again reflected in a belief that the only way to recoup or pay off debts is to gamble even more. Loans are due, bookies are seeking payment, and the entire situation begins spiraling out of control. Those who have jobs may embezzle from their employer. Others may make fraudulent loan applications or insurance claims. Many will resort to theft for the money. Initially, the pathologic gambler rationalizes these crimes. He will repay it all... it is just a loan... he really isn't a criminal. A cycle of tapping all resources, pawning items, taking out loans, embezzlement, theft, lies, rinse, and repeat ensues.
During the desperation phase pathologic gamblers lose all control over their gambling. Desperate gamblers see heightened gambling activity as the only chance for survival. Although desperate gamblers feel ashamed and guilty after gambling, fundamentally they cannot stop. They frequently resort to illegal activities to finance their addiction. At this point, the consequences of compulsive gambling invariably catch up with them; they get fired, divorced, forced into bankruptcy, or arrested.