A 48 year old man attempted suicide. He had left a note to his wife apologizing for exhausting their children’s college funds and for bringing the family to bankruptcy. His wife believes he has a serious gambling problem; he spends his pay on lottery tickets and sporting event bets.
What this person needs is as education about the disorder of compulsive gambling and treatment. Unbiased, practical advice may assist a patient who’s overwhelmed by the personal, social, and financial chaos associated with gambling.
He needs to be assured that he has a treatable disorder. Life may seem hopeless to him; an understanding clinician with basic theoretical knowledge about addiction and links to resources can make a difference. He needs anattitude of"I realize that your problems may seem insurmountable right now. With help, your dependence on gambling can become manageable."
Pathologica gambling is an impulse-control disorder characterized by emotional dependence on and preoccupation with gambling, a loss of control, and an inability to quit despite debt or significant social, occupational, or legal problems. Each year, this disorder affects about 1% of the general adult population, and lesser ‘problem’ gambling problems occur in another 2.8%. Compulsive gambling can lead to anxiety, depression, substance abuse, and family dysfunction.
A gambling disorder can take many forms, and affects men and women of all ages and socioeconomic groups. Compulsive gamblers may use state lotteries, charity bingo games, the stock market, slots, poker machines and Internet gaming sites to feed their obsession.
As the issue of gambling becomes more prominent (with more legalized casinos and government-sponsored lotteries), educational and referral resources are becoming more numerous. Gamblers Anonymous offers group support based on the 12-step model. Psychopharmacologic treatment may only relieve symptoms: Recent preliminary research supports the efficacy of Prozac and other selective serotonin reuptake inhibitors (SSRI’s) in curbing the craving to gamble. Counseling can be successfully employed, though there are few established gambling addiction treatment programs in existence and it may be difficult to locate an experienced counselor. Financial and consumer credit counselors may help avert some of the economic consequences of compulsive gambling.
It’s imperative initially to address this mans suicidal ideation and depression. He needs to be encouraged to get help and to discuss the financial and emotional consequences of his behavior with his family. This may include having him explore his fears about family members’ reactions to his addiction.
Unlike alcohol or drug addictions, there usually aren’t striking physical warning signs of gambling problems, so they can go undetected until a patient asks for help for a another condition such as depression or attempted suicide. Compulsive gambling is insidious; it’s sometimes difficult to distinguish pleasurable diversion from pathologic behavior. Most compulsive gamblers expertly cover the problem; family members may talk about unusual behaviors the gambler may exhibit, such as suddenly withdrawing money for unspecified reasons. The gambler may talk about gambling triggers, such as going on a business trip.
Compulsive gambles have a psychological disorder, not a moral defect. Spending the rent money or the children’s college funds on gambling may seem reprehensible, but it’s a symptom of an illness. As with alcoholism and other addictions, research suggests a possible genetic link or biologic origin for compulsive gambling.
People with gambling disorders face long and often daunting recoveries; they need help to take the first step.
Source; Eber, Gabriel & Gorman, Mary. When Gambling Becomes a Losing Battle. American Journal of Nursing, Volume 99(5) May 1999 p 22