Gambling – A Complicated Activity With Dangerous Consequences

Despite its relatively innocuous appearance, gambling is a risky activity with potentially harmful consequences. Psychiatrists and other treatment care clinicians are increasingly evaluating patients for gambling-related problems. As with drug addiction, pathological gambling is often viewed as a mental illness. However, the validity of this view is challenged by the lack of an agreed upon nomenclature that can facilitate communication among a diverse group of interested parties (see Box).

Gambling involves the putting up of something of value for a future uncertain outcome. Although it is commonly associated with money, it may also involve a variety of other items that can have significant value (e.g., vehicles, houses, and art). It may be undertaken for social or business purposes or for entertainment. People may play casino games, buy lottery tickets, and bet on sports events. Other forms of gambling include keno, scratch-off tickets, and DIY investing.

Like other addictive behaviors, gambling has a complex etiology, and its effects vary from person to person. Many gamblers do not experience any harm from their behavior, while others are addicted and do not know it. Gambling is a common source of family conflict and financial difficulties, and some people hide their gambling, lie about it to their family members, and even try to get rid of their winnings. Some people are preoccupied with thinking about gambling, while others find it a pleasant escape from unpleasant or stressful life events.

The most common reason for someone to start gambling is that they want to win money. This could be for a specific purpose, such as paying off debts or helping to provide for a family, or it could be for an ill-defined “fun.” People can also be motivated by the prospect of status and specialness: they may think that if they can get in on the ground floor of a new casino they will be rich. This type of motivation is often called the “greed factor.”

Another motivating force for gambling is a feeling of excitement or a rush that comes from taking risks or believing in luck. This feeling can be particularly strong for those who do not enjoy the same level of pleasure from other activities or if they feel that their lives are stagnating. Lastly, some people find comfort in gambling as a way to meet a basic human need for self-esteem or belonging.

Some experts argue that it is illogical to classify gambling as a psychiatric disorder because it does not involve ingesting chemicals and thus cannot be compared to substance dependence. Furthermore, there is no evidence that people with a pathological gambling problem have underlying mental disorders such as depression or schizophrenia. Others point to the similarities between the impulsivity, risk-taking, and false sense of control that characterize both disorders. Nevertheless, the existence of these symptoms is consistent with the idea that gambling is a learned response that hijacks the brain’s natural learning mechanism through random rewards.