Gambling Disorder (Compulsive Gambling, Pathological Gambling)

Betting the farm can actually be a serious problem for some people. Compulsive and habitual gambling can destroy a person's life. He likely suffers personal problems and financial ruin. Problem gambling can sometimes even lead to a life of crime.


A compulsive, or pathological, gambler is someone who is unable to resist his or her impulses to gamble. This leads to severe personal and, or, social consequences. The urge to gamble becomes so great that tension can only be relieved by more gambling.

There is a very fine line between problem gambling and gambling too much. The critical sign of problem gambling is often hidden from awareness, with denial. Many gamblers typically do not know they have a problem. Admitting you have a problem, or may have a problem, is the first step to recovery. Unfortunately this realization normally only surfaces when a problem gambler hits rock bottom.

This was formerly a compulsive disorder, and now considered an addiction disorder in the DSM-V.


How do you know if you are a compulsive, or pathological, gambler?

Although some people like to gamble occasionally, the pathological gambler usually progresses from occasional gambling to habitual gambling. As the gambling progresses, the gambler begins to risk more—both personally and financially. This often leads to severe personal problems, financial ruin and criminal behavior to support the gambling habit.

Pathological gambling is indicated by demonstrating four (or more) of the following in a 12-month period (mild four to five criteria met, moderate six to seven criteria met, severe eight to nine criteria met):​

  • Needing to gamble progressively larger amounts of money to feel the same or more excitement
  • Having made many unsuccessful attempts to cut back or quit gambling
  • Feeling restless or irritable when trying to cut back or quit gambling
  • Preoccupation or excessive thoughts (e.g., previous gambling experiences, planning the next gambling venture, ways to get money to gamble with again)
  • Gambling increases, and may even occur to escape problems/feeling distressed (feeling helpless or guilty), or feelings of sadness, or anxiety are present  
  • Gambling larger amounts of money to try to recoup previous losses (chasing previous gambling losses)
  • Lying about the amount of time or money spent gambling
  • Losing a job, relationship, or educational or career opportunity due to gambling
  • Relies on others to borrow money to get by due to gambling losses, especially when financial situations become desperate due to involvement in gambling 

Gambling addiction is a significant problem in the United States, impacting adults of all ages. It affects 1 to 3 percent of adults, men more often than women. It usually begins in adolescence in men and later in women. Until recently, legal casino and sports betting were limited to few states. The growth of riverboat and Indian casinos, state and national lotteries, and Internet access to offshore sports and parlor betting has dramatically increased access for all adults, including seniors. Older adults are, perhaps, more vulnerable than other age groups given their greater dependence on fixed incomes and more limited ability to recover from gambling losses.

Possible Complications

People with pathological gambling behavior often have problems with alcohol and other substance abuse, depression, and anxiety. People with pathological gambling behavior often consider suicide, and some of them attempt it.

People with pathological gambling behavior tend to have financial, social, and legal problems. These can include bankruptcy, divorce, job loss, and time in prison. The stress and excitement of gambling can lead to heart attacks in people at risk for them. Getting the right treatment can help prevent many of these problems.


Pathological gambling usually begins in early adolescence in men, and between ages 20 and 40 in women.

Pathological gambling seems to be similar to disorders such as alcoholism and drug addiction. In people who develop pathological gambling behaviors, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.


Compulsive gambling can be treated. Treatment begins with the recognition of the problem.

Treatment options include individual and group psychotherapy, and self-help support groups such as Gamblers Anonymous. This is a 12-step program similar to Alcoholics Anonymous. Abstinence principles that apply to other types of addiction, such as substance abuse and alcohol dependence, are also relevant in the treatment of compulsive gambling behavior.

Recently, medications such as antidepressants, opioid antagonists, and mood stabilizers have been shown to be beneficial in combination with psychotherapy.

Like alcohol or drug addiction, pathological gambling is a chronic disorder that tends to get worse without treatment. Even though with treatment, it's common to start gambling again (relapse), people with pathological gambling can do very well with the right treatment. Many people are able to gain control over their lives after undergoing treatment.

Find a Treatment Center here.


Prevention is challenging and may not always be possible. Exposure to gambling may increase the risk of developing pathological gambling. Limiting exposure may be helpful for people who are at risk. Public exposure to gambling, however, continues to increase in the form of lotteries, electronic and Internet gambling, and casinos. Intervention at the earliest signs of pathological gambling may prevent the disorder from getting worse. Counseling may benefit people who are prone to compulsive gambling or other addictive behaviors. People who are aware that compulsive gambling affects close relatives might be at higher risk and should be especially careful.


  • Gambling and Older Adults
  • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
  • National Institutes of Health - National Library of Medicine

Last reviewed 02/07/2019