The uncontrollable urge to gamble recklessly is called pathological gambling, or ludomania. Pathological gamblers bet more than they can afford to lose, and they continue to wager and lose money in spite of significant losses. Experts disagree as to how pathological gambling should be classified. Some say it's an impulse control disorder; others call it an addiction (click to read). In order to be diagnosed with pathological gambling, a gambler must display certain specific characteristics as defined by the DSM-IV. Some of these characteristics include lying about casino gaming and other personal activities, loss of important relationships due to gambling and criminal activities. Although it is rather easy to describe the characteristics of the pathological gambler, the causes of the disorder are more difficult to pinpoint. Researchers have identified the following four psychiatric conditions as possible risk factors for the disease.
Depression can be caused by low levels of a chemical in the brain called serotonin. Serotonin is a neurotransmitter that controls mood. When serotonin levels are too low, a person's mood may plummet into depression. Depressed people feel emotional discomfort, yet they are often unable to ameliorate their discomfort through normal coping mechanisms. These feelings of discomfort may prompt them to self-medicate with pleasurable vices that temporarily raise serotonin levels, such as overindulgence in food, alcohol, drugs, and gambling.
Like people who are depressed, pathological gamblers often have lower-than-average levels of serotonin in their brains. Scientists have found a concrete link between depression, low serotonin, and pathological gambling.
A 2009 research study reported in the journal Psychopharmacology described rats with low serotonin levels who readily engaged in the same types of risky behavior as pathological gamblers. The study suggests that depressed people, like the rats in the experiment, may also be more inclined to gamble pathologically as a result of their brain chemistry.
The relationship between low serotonin levels and pathological gambling is significant. Fortunately, doctors and therapists may have some control over pathological gambling in people who are depressed. With medication, low serotonin is often a treatable condition. Clinical trials suggest thatantidepressant medications may help prevent, and sometimes even cure, this insidious problem. Results are inconclusive at this point, but scientists are hopeful. Research continues.
Schizophrenia is a serious brain disorder in which patients perceive a distorted reality. They may hear voices, imagine threats that aren't really there, and suffer severe bouts of anxiety and paranoia. Scientists believe that, like clinical depression, schizophrenia is at least partially caused by a neurotransmitter imbalance in the brain. That imbalance pertains, among other things, to a brain chemical called dopamine. Dopamine is a complex substance that plays a critical role in a person's motivation and their response to pleasure and punishment.
Unfortunately for schizophrenia patients, addiction often comes part and parcel with the diagnosis. Victims historically report problems with risky, excessive behaviors like smoking, substance abuse, and gambling. A survey reported by the Journal of Clinical Psychology showed that almost 60 out of 300 schizophrenics had significant problems with gambling. Approximately half of those patients reported symptoms severe enough to meet the DSM-IV pathological gambling criteria. This means that a staggering 10 percent of schizophrenia patients may suffer from pathological gambling.
Schizophrenia is a chronic condition that can be managed, but not cured. Anti-psychotic medication is usually prescribed, but unfortunately presents an array of unpleasant side effects. The disease sometimes culminates with the patient developing disabilities like quadriplegia, dementia, and evensuicide. Many schizophrenics, however, are able to thrive thanks to combination of medication, talk therapy, and behavioral and cognitive interventions.
Antisocial Personality Disorder
Antisocial personality disorder is a condition in which patients, who are often criminals, have little or no regard for the feelings and well-being of others in society. The ASPD patient may display behaviors that are excessively violent, narcissistic, belligerent, greedy, or reckless. Once again, the culpable neurotransmitter implicated in many cases of ASPD is serotonin.
The correlation between ASPD and problematic gambling is high. In one study, almost half of a sample of ASPD-diagnosed patients reported taking part in a gambling-related criminal offense. It is estimated that 15 percent or more of pathological gamblers may have this personality disorder.
Scientists believe that a mixture of environmental and genealogical factors contribute to the development of ASPD. Child abuse and other early childhood traumas are often pinpointed as a significant cause of the problem. In addition to pathological gambling behaviors, ASPD patients may suffer depression, anxiety, and social isolation. They often spend time in jail. The disorder is difficult to treat, as patients are often unwilling to cooperate with health care providers. Psychosocial therapyand psychotropic medications have been used with success in some patients.
Bipolar Disorder is a mood condition in which victims vacillate, often violently, between mania and depression. A bipolar person may experience periods of hypomania, characterized by extreme diligence, productivity, and focus, followed by periods of severe depression, sometimes with psychotic features. Scientists believe that an abnormal brain structure may be at least partially to blame for the dramatic mood swings which characterize bipolar disorder.
Bipolar disorder and pathological gambling notoriously go hand in hand. A 2007 study in the Journal of Affective Disorders found that victims of bipolar disorder are more than twice as likely as mentally healthy people to develop a gambling addiction. In cases where a bipolar patient is hooked on drugs or alcohol, the development of pathological addiction may be even more likely.
The good news for bipolar sufferers is that the disease is often managed well with medication.Lithium is the drug of choice in most cases. Although the disorder is chronic and cannot be cured, therapy can help with gambling addiction and other problems of excess.
Not all people with depression, schizophrenia, antisocial personality disorder, and bipolar disorder become pathological gamblers. A person's chances for gambling pathologically are higher, however, if they have one of these diseases. Scientists continue to pursue medications and other treatments to help psychiatric patients with pathological gambling problems lead healthier, happier lives.