Gambling Addiction: Symptoms and Causes

What is gambling addiction?

Gambling addiction is a behavioral addiction to gambling: betting, casinos, lotteries, poker for money, offline or online. There is no substance involved, but the mechanism is similar to chemical addictions: anticipating a win reinforces the brain’s reward system, and over time the person plays longer and bets more to feel the same thrill.

In the international classifications of diseases, it is a separate diagnosis. In ICD-10, which is still used in Ukrainian medical records, it is F63.0 “Pathological gambling.” In the World Health Organization’s ICD-11, it is 6C50 “Gambling disorder” in the group of disorders due to addictive behaviors.

These codes should not be confused with “gaming disorder” (ICD-11 6C51). That diagnosis concerns computer and video games, where betting money is not the point of the game. Gambling addiction is specifically about gambling for money. In Ukraine, medical care for it is described in the Ministry of Health clinical protocol “Gambling Addiction (Ludomania),” approved by Order No. 1201 of 10.07.2024.

This is not a matter of “willpower.” As with chemical addictions, neurobiological mechanisms are involved, so gambling addiction is rarely overcome by a decision to “just stop.”

What causes gambling addiction?

Gambling addiction rarely has a single cause. It is usually a combination of psychological traits, social environment and, sometimes, biological predisposition.

Gambling addiction often “masks” other difficulties: anxiety, depression, loneliness, chronic stress. Gambling briefly shuts these feelings out, and then becomes a problem in its own right.

What are the symptoms of gambling addiction?

The symptoms of gambling addiction show up in three areas: behavior, finances and emotional state. A single loss or one evening at a casino means nothing. The warning sign is a recurring pattern that intensifies over time.

How is gambling addiction different from enjoying gambling?

What sets gambling addiction apart from a hobby is not the fact of gambling or the amount of money, but loss of control. ICD-11 describes gambling disorder by three features: the person cannot control their gambling (when to start, how long to play, when to stop), gambling takes priority over other interests and daily activities, and the person keeps gambling despite harm. A doctor usually diagnoses the disorder when this pattern has lasted at least 12 months and noticeably harms the person’s work, relationships, finances or well-being. With severe symptoms, the diagnosis may be made sooner.

In practice it looks like this:

• the person needs bigger and bigger bets to get the same thrill;
• they have already tried to cut down or stop gambling and failed;
• gambling continues despite debts, family conflicts and problems at work;
• much of their time goes into gambling, thinking about it or finding money for it;
• a loss triggers an urge to “win it back” immediately rather than stop.

This list is not a test or a diagnosis. If you recognize yourself or someone close to you in it, it is worth consulting a psychotherapist or psychiatrist, even if the person insists they are “in control.”

What are the consequences of gambling addiction for the person and the family?

The most visible consequences of gambling addiction are financial: debts, loans, drained family savings. The emotional ones are just as serious: anxiety, depression, guilt and shame, and trust in the family broken by secrecy and lies.

If there are children in the family, they feel the consequences too: instability, their parents’ anxiety, conflicts over money, even if they don’t understand the cause. Rebuilding trust after gambling addiction is a separate process. It usually takes longer than giving up gambling and also needs support from a specialist, not just time.

During this period, the people close to a gambler often develop codependency: their own peace of mind and decisions become entirely tied to the gambler’s behavior. This can also be addressed separately.

WHO notes that gambling is associated with an increased risk of suicide. When debts seem insurmountable and shame is overwhelming, a person may have suicidal thoughts. This is an acute condition, not a “character flaw.” If there is an immediate threat to life, call 103 or 112. If there is no threat right now, contact a 24/7 psychological support line or a crisis psychologist, and don’t face this alone.

What should you do if the signs match?

The first step is a conversation with a specialist — not an attempt to “pull yourself together” alone or, conversely, a family blowup with ultimatums.

1. Write down the facts. Specific amounts, times, how long this has been going on and what has already happened because of gambling.
2. Consult a specialist. You can go yourself, even without the person who gambles. A psychotherapist will help assess the situation and plan the conversation.
3. Take care of the family. Loved ones also go through stress and guilt, and they may need separate support. The types of care are described in the “Rehabilitation” section.
4. Move on to structured work on the addiction when the person is ready. How this care is organized is described on the “Gambling addiction rehabilitation” page.

Frequently asked questions

Can you cope with gambling addiction on your own, without a specialist?

Sometimes a person manages to gamble less often on their own, but loss of control rarely goes away without outside help: the addiction mechanism sustains itself. Working with a psychotherapist gives a better chance of lasting change than trying to cope alone.

How is gambling addiction treated?

The core of care for gambling addiction is psychotherapy. According to WHO, long-term cognitive behavioral therapy and motivational interviewing have the strongest evidence. If gambling is accompanied by depression, an anxiety disorder, suicidal thoughts or dependence on alcohol or other substances, a psychiatrist’s help is also needed. Whether medication is needed is decided only by a doctor after an examination. How this works at the clinic is described on the “Gambling addiction rehabilitation” page.

Can you help a person who doesn’t admit the problem?

An adult cannot be forced into treatment. But family members can seek a consultation themselves. A specialist will help them approach the conversation so that it is easier for the person to come for help, and will support the family regardless of the person’s decision.

How long does psychotherapy for gambling addiction take?

It is usually not a matter of a few sessions. Lasting behavior change takes several months of regular work, sometimes longer. The duration depends on how long the addiction has lasted and whether there are co-occurring conditions such as anxiety or depression.

How is online betting different from playing at a casino in terms of addiction?

The addiction mechanism is the same. But online betting is available 24/7, from a phone and without anyone watching, so a person may lose control faster and the family may notice the problem later. ICD-11 even distinguishes separate subtypes of the disorder: predominantly offline and predominantly online.

Is online psychotherapy possible for gambling addiction?

Yes. Whether sessions are in person or remote is agreed with the specialist. WHO notes that there is some evidence that online therapy for gambling disorder works, but people drop out of it more often. That is why it is important to agree on a regular schedule.

Is seeking help anonymous, and how much does it cost?

How confidentiality works and who can find out that you sought help is explained in the article “Anonymous Addiction Treatment”. Current consultation prices are on the “Prices” page.

This article is for information only and does not replace a consultation with a specialist. If gambling addiction has led to suicidal thoughts, call 103 or 112 immediately, or a 24/7 psychological support line.