Betting on Trouble: The Alarming Truth About Gambling Addiction

We are, says Dr. Marc Potenza, all born gamblers. ‘We’re evolved to make decisions regarding risk and reward, and to engage in those processes – finding food, for example, and going back to those places where we found food – and for that engagement to be an advantageous trait’. Our ability to engage in betting, says the specialist in addiction psychiatry at the Yale School of Medicine, is vital to our survival as a species.

Yet for a small minority – an estimated 1 to 2 per cent of the general population – this develops into what has come to be called ‘gambling disorder’. This is often catastrophic to their health, not to mention relationships, social life, employment and, of course, finances. If you’re a pathological gambler you’re more likely to sleep much less than average, and smoke, drink and binge eat more, and suffer from chronic stress. Almost a quarter of pathological gamblers will attempt suicide at some time in their lives. 

That’s worrying when gambling rates are on the increase: partly a habit developed over the boredom of the pandemic, partly in response to the advent of mobile, app-based gambling, which allows the itch to be scratched 24/7. But there’s a third factor that science is, very slowly, coming to understand better: predisposition. In other words, the make-up of our brains. 

‘As with any any other behavioural disorder, the behaviour is a blend of biology mixed with cultural, social and environmental factors. I have gambling disorder patients tell me they feel sweaty and alive when they gamble. They talk of feeling sucked in. Yet other people feel absolutely nothing, and it’s just as interesting to ask why some people are so averse to it,’ says Dr. Timothy Fong, clinical professor of psychiatry at the UCLA Gambling Studies Program. ‘Gambling just isn’t the same experience for everyone. But the problem is the same – not being able to pull away from it.’

The Science Behind Betting

Potenza’s neuro-imaging studies have revealed how the brain regions involved in pathological gambling are similar to those involved in drug or alcohol addictions: the function of the prefrontal cortex – the seat of rational choices, where decisions are made about whether, say, to choose a small but immediate reward against a later, larger one – takes a hit.

Other research suggests that the rush of gambling likewise diminishes over time too, with an actual corresponding drop in electrical activity in the reward centres of the brain. What do problem gamblers do to compensate? They chase the buzz they’ve grown used to by placing ever larger bets, or trying other forms of betting until they’ve tried them all.

Other studies, looking at the neuro-chemical drives, suggest that gambling causes a spike in the brain’s reward system, promoting the release of chemical messengers dopamine and serotonin. These are associated with feelings of pleasure, satisfaction or happiness, but also risky behaviour. Some studies suggest that gambling addicts get a bigger kick out of this dopamine than non-addicts. That may explain why, while most of us unconsciously enjoy the release of dopamine, most of us don’t pursue the behaviour that causes that release over and over.

And then there is the psychology that’s particularly acute with problem gambling. There’s what’s called intermittent reinforcement, the hard-to-break sense that every loss just takes you one more step towards the win. There’s the ‘loss disguised as a win’: a small win that’s lower than the stake. Or the ’near miss’ effect: two matches and nearly-but-not-quite three on the slots, for example. 

These mechanisms keep you gambling against the rational conclusion that you are, in fact, losing. Those betting apps are adding to the problem psychologically too: addictive gambling is encouraged by being free to gamble both alone and rapidly. That’s why the frequency of bets placed on slot machines is so much more enticing than the long-range play of a lottery.

‘It’s these kinds of [psychological effects] that keep some people gambling. And the designers of gambling games very consciously know that too,’ says Dr. Stephen Sharman, a researcher in gambling behaviour at the University of London. ‘They devise games to trigger the brain to think you’re constantly winning when in fact you’re losing. In fact, the whole gambling industry is based on finding ways to make losing feel pleasurable so gamblers keep coming back’

The Gambling Profile

That’s not all the industry knows. It’s aware that you’re twice as likely to become a problem gambler if you’re a man, though whether that’s down to hormones, culture, environment or something else isn’t yet clear. It knows that male problem gamblers are more likely to be poorly educated, but that female problem gamblers will more highly educated – and it now consciously targets well-educated women in its advertising.

And it gets scarier. If you’re a pathological gambler, you’re also likely to have brain impairments such as deficits in attention and frontal lobe functioning. However it’s not clear if that’s cause or effect, or genes, suggesting pathological gambling may be hereditary.

But why gamble so persistently in the first place?

It’s not about the money. In fact, some gamblers get a positive response even when they lose. That’s because betting is often a means of temporarily dialling down more persistent negative emotions – and there may be something in the fact that the small number of pathological gamblers is roughly the same percentage of the general population who will have some other major mood disorder, the likes of being depressive, schizophrenic or bi-polar.

Potenza notes how some people in chronic pain no longer feel it when they’re betting; how others enter what he calls a ‘dark flow state’ that allows them to forget everything that’s going on in the rest of their life.

‘Lots of my patients tell me the really intense feeling they have is [not when gambling but] in anticipation – on the drive to the casino, or right before they sit down,’ adds Fong. ‘For years people have misunderstood gambling disorder as being an obsession with winning. Or about greed. But winning is just the means to keep on playing. They’re under this zombie effect. They just can’t stop.’

Sadly, most pathological gamblers never try to, and most of those that do seek treatment tend to relapse. On the plus side, those that manage to stay the course typically make a full recovery. But, Fong argues, while there is still much yet to understand about what’s going on inside – while we gamble, that makes us want to gamble – society needs to do more now to address the problem. At the least he’d like to see schools teach more financial literacy, and for the betting industry’s ability to promote what typically gets passed off as a harmless entertainment, seriously curtailed.