Gambling is defined as wagering an item of value in the hope of getting something more valuable in return. It is a very common behavior in the United States. Eighty-five percent of American adults report having gambled at least once in their lives, according to the National Council on Problem Gambling (NCPG). Sixty percent have gambled in the past year.

Most adults are able to gamble responsibly. However, a small percentage of people who gamble develop an addiction to it. Gambling behavior that becomes excessive and continues despite serious financial, relationship and work problems is considered pathological (or compulsive). The American Psychiatric Association (APA) classifies pathological gambling as an impulse control disorder with specific criteria for its diagnosis.

Gambling activities can take many different forms. Among the most common in the United States are lotteries, casinos and sports betting, but card games, cockfights, and horse and dog races are other forms of gambling. In addition, gambling via the internet has become increasingly popular in recent years. In terms of gambling addiction, the type of gambling activity is not as important as the extent to which a person is gambling, and the effects of gambling on the person’s life.

When, how and with whom people gamble can determine the type of their gambling behavior and extent of their addiction:

• Social gambling. Recreational gambling that is done with friends, for a set period of time and with a set limit on acceptable losses.
  
  
• Professional gambling. Gambling behavior marked by strict self-discipline and limited risk-taking.
  
  
• Problem gambling. Behavior that meets several of the APA criteria for pathological gambling, but not enough for an actual diagnosis. People with this type of behavior usually experience financial and/or social difficulties as a result of their gambling.
  
  
• Pathological gambling. Gambling that is repeated, despite a loss of control over betting and serious personal and financial consequences. Pathological gambling is a psychiatric problem classified as an impulse control disorder by the APA.
  

Pathological gambling affects approximately 2 million adults in the United States, according to the NCPG. In addition, another four to eight million are problem gamblers – people who meet some, but not all of the criteria necessary for a diagnosis of pathological gambling. Although gambling addiction is a mental health disorder that can be treated, many pathological gamblers deny or hide their behavior and are reluctant to seek help, making it difficult to identify and treat the condition.

A gambling addiction may involve distortions of thought (e.g., overconfidence, a sense of control over chance) and develops in a similar manner to substance abuse. This includes a growing tolerance to the risks necessary for the “rush” of a win, requiring the gambler to risk greater amounts of money to achieve the desired level of excitement. Also, pathological gamblers experience withdrawal when not gambling and become preoccupied with anticipating the next occasion in which they can gamble. Finally, relapse of the behavior is common.

For someone with a gambling addiction, the behavior tends to recur in cycles. Gambling success leads to more gambling, which, in turn, leads to overconfidence and greater amounts of risk-taking. Gambling loss leads to more gambling in an effort to recuperate losses. Either way, the behavior is reinforced and continues.