Rehab 4 Addiction

When we think about addiction, our minds tend to lead us to alcohol and drug addiction. Whilst addiction to drugs and alcohol form the bulk of addictions, the range of foci for addictions is huge.

The clinical definition of addiction is a chronic, relapsing disorder characterised by the compulsive seeking of the focus of the addictive behaviour despite harmful consequences caused by its continued use.

This can cause long term brain changes and for this reason, addiction is not only considered a mental illness but also a brain disorder [1].

As such, one can have addictions to many different things from sex to video games. Even activities considered healthy like exercise can lead to addictive behaviour when carried out to excess, often going hand in hand with other complex issues such as body dysmorphia.

The common thread through all of these addictions is their capacity to provide short term highs.

Gambling addiction, which this article will cover, can certainly provide those highs. Read on to discover what gambling addiction is, how to recognise it either in yourself or those close to you, and most importantly, how you can overcome gambling addiction by finding the right help.

What is Gambling Addiction?

Gambling is loosely defined as the wagering of something valuable on an event who’s outcome is uncertain. The main goal is of course to win something valuable, money or otherwise depending on that outcome. Therefore, gambling always involves risk, consideration and the prize.

Gambling has been practised as an enjoyable pastime by humans for millennia, dating back to prehistoric times There’s even evidence to show that six-sided dice were being used as far back as 3000 BC in ancient Mesopotamia [2].

As with many of life’s pleasures, from eating chocolate to receiving a hug, that fantastic feeling you get when you’ve just won a gamble is a sign that the areas of your brain, namely the ventral striatum located deep in the brain, has been activated [3].

This is a useful evolutionary pathway that we as a species developed over time, useful in that it drives us to repeat the activities that feel good. In evolutionary terms, something that felt good was likely to have benefited our ancestors.

The flip side of this is of course when the compulsion to repeat the activity becomes uncontrolled leading to a person needing to repeat the activity more and more and at higher intensities to get the same ‘high’, in other words, tolerance, a hallmark of addiction.

This can certainly happen in gambling addiction where people report that they find themselves needing to take bigger risks with increasingly higher stakes.

Another hallmark of addiction is withdrawal whereupon stopping the activity, people experience unpleasant symptoms including agitation, insomnia and irritability, again, all of which have been documented in those who have a gambling addiction [4].

The brains of those suffering from gambling addiction have been studied using fMRI (functional magnetic resonance imaging). fMRI is a way of seeing which areas of the brain are active as shown by increases in blood flow to specific area.

These areas of increased blood flow then light upon the image of the brain generated by the MRI machine in real-time. Such studies have helped improve our understanding around why some are more prone to their gambling habits to turn problematic than others.

Interestingly, in one such study, when people with gambling addiction and another group with cocaine addiction were scanned whilst watching videos related to their respective addiction, both showed a decrease in the activity of the brain’s reward system compared to health controls. The same effect was shown amongst gamblers even during simulated gambling exercises [5].

Whilst this may at first seem counterintuitive, these studies demonstrated that those prone to addiction may have underactive reward systems and instead seek ways to stimulate the reward pathway further.

Studies such as these also highlighted that gambling addiction can have the same mechanism behind them as any other more ‘traditional’ addictions such as drugs. Furthermore, similar studies also employing fMRI have demonstrated that an area of the brain called the prefrontal cortex can also be involved in addictive behaviour.

This area of the brain plays a role in impulse control and decision making. Again, it has been shown that people who are addicted to drugs or gambling have reduced levels of activity in this area when given gambling-related cues [5]

Despite this evidence, it is only fairly recently in 2013 that problematic gambling was considered a true addiction in the DSM-5 or Diagnostic and Statistical Manual, sitting in the same category as drug and alcohol addiction.

This classification has been helpful in determining that an estimated 350.000 in the UK alone suffer from gambling addiction [6]. Given these numbers, if gambling addiction is something that you or somebody close to you suffers from, you are certainly not alone.

How to Recognise Gambling Addiction

Again, similar to substance addiction, gambling addiction can cause serious problems in your finances, relationships with others and can even spill over into other aspects of your mental and physical health.

These problems can be further compounded by unscrupulous companies with unfair gambling practices, particularly in the case of fixed-odds betting terminals which have now been subjected to a governmental crackdown.

Given the costs have the potential to be so high, it is important to be aware of the telltale signs of gambling addiction, especially given that the line between having fun with gambling as a pastime and having an addiction is so thin.

If you are concerned about yours or a loved one’s gambling habits, you may want to look out for the following:

  • Always wanting to feel a real rush of adrenaline as you participate in gambling activities
  • Boredom, wanting to pass time when you aren’t gambling
  • Preoccupation with gambling or thinking about gambling swallows up more and more of your time, leading you to increasingly loose interest in other aspects of your life
  • Having to increase the money gambled to experience the same thrill
  • Signs of strain on your relationships, family and friends as you can no longer focus on them, devoting all of your thoughts and time to gambling
  • Becoming secretive and defensive by concealing how much time and money you have spent on betting
  • Problems at work as you struggle to maintain concentration on the task at hand in order to complete them sufficiently. This could lead to job instability
  • Loss of ability to control impulsions and urges to gamble even when the odds are not in your favour
  • Getting into financial difficulties because of a direct or indirect consequence of gambling addiction such as loss of your job and income
  • Denial that you have a problem with gambling

Where to Get Help with a Gambling Addiction & Gambling Rehab

If you recognise any of the features of gambling addiction outlined above in you or someone you care about, please know that there is always help available to help you overcome the problem.

Whilst the nature of gambling addiction, like any addiction, is chronic and long term, many can and do manage to maintain long periods of freedom from addiction.

When they relapse, many have the tools to get back on track in a minimal amount of time provided they receive the right support and guidance.

The NHS is always a good place to start and their website [7] has a handy set of questions to help you realise whether you have a problem with gambling. They also have a range of self-help tips that you can practice whilst you receive support and treatment to overcome your problem.

The mainstay of therapy for gambling addiction is a type of clinically approved talking therapy, cognitive behavioural therapy (CBT), carried out with a trained professional to help shift your mindset around gambling, leading to healthier habits and lifestyles.

Similar to the treatment of other types of addiction, the therapy you receive may be in a dedicated rehab facility, depending on the severity of your addiction.

Some are residential where you stay on site overnight and others are day centres. In rehab, you will be surrounded by experienced professionals who can support you and facilitate your therapy.

For example, if you experience those symptoms of withdrawal as detailed above, staff will be on hand to guide you through it to the other side. Programmes vary in length depending on the facility but in inpatient facilities, may extend to 12 weeks.

Depending on which facility you choose, there may also be complementary therapies available such as art and music therapy, both of which have been clinically proven to promote your journey towards freedom from gambling addiction.

If you would like to access this type of support, you can refer yourself to the National Problem Gambling Clinic if you are over 16 and live in England or Wales [8] who can point you in the right direction and provide advice on choosing treatment options.

There is also support available from a number of charities dedicated specifically to people with gambling addiction, many of which have a free phone number that you can call to access support, advice and counselling.

Examples of such organisations are Gamcare [9] and Gamblers Anonymous UK (10) which runs in a similar way to the widely known Alcoholics Anonymous group.

If you are the family or friends of somebody with a gambling addiction that you care about, there is also specific advice available through GamAnon [11], also run by Gamblers Anonymous UK with meetups in a range of locations throughout the UK and the Gordon Moody Organisation’s Gambling Therapy site [12].

The HelpGuide organisation’s website [13] is also a fantastic resource with plenty of practical advice for those with an addiction to gambling and their contacts.

Of course, it always goes to say that if you are concerned about yourself or a loved one, you can talk to your GP who should be able to signpost you in the right direction. The first step towards recovery from gambling addiction is acknowledging that there is a problem.

References

[1] https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics

[2] https://gamban.com/blog/a-history-of-problem-gambling

[3] https://www.ncbi.nlm.nih.gov/books/NBK92777/

[4] https://pubmed.ncbi.nlm.nih.gov/19197945/

[5] https://pubmed.ncbi.nlm.nih.gov/28456569/

[6] https://pubmed.ncbi.nlm.nih.gov/28456569/

[7] https://www.nhs.uk/live-well/healthy-body/gambling-addiction/

[8] https://www.cnwl.nhs.uk/services/mental-health-services/addictions-and-substance-misuse/national-problem-gambling-clinic

[9] https://www.gamcare.org.uk/

[10] https://www.gamblersanonymous.org.uk/

[11] http://gamanon.org.uk/

[12] https://www.gamblingtherapy.org/

[13] https://www.helpguide.org/articles/addictions/gambling-addiction-and-problem-gambling.htm