Gambling Addiction and Mental Illness
Gambling disorder is widely recognised as a mental health condition, appearing in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11). But is it treated as a disorder like depression or anxiety, or is it seen as a different kind of addiction?
In the DSM-5, gambling disorder is placed in the same category as substance use disorders, separate from impulse-control disorders. This reflects a shift in how gambling addiction is understood, moving away from seeing it as an issue of self-control and towards treating it as a compulsion driven by addictive mechanisms in the brain.
The DSM-5 defines gambling disorder as a persistent, recurrent pattern of gambling leading to negative consequences, with 4 or more of these criteria within a 12-month period. The core features include:
- Needing to gamble with increasing amounts of money
- Attempting to "cut back" or stop gambling, but failing
- Being restless or irritable when trying to cut down or quit
- Using gambling to escape problems or relieve negative mood
- Chasing losses by gambling more
- Lying to conceal the gambling extent
- Jeopardising a relationship or opportunity
- Requiring another to relieve a desperate money situation caused by gambling
ICD-11 frames gambling disorder as a disorder due to addictive behaviours, with three key features:
- Impaired ability to control gambling
- Growing priority of gambling over other interests
- Continuation or escalation despite negative consequences
The gambling must cause significant impairment or distress in important areas of functioning, and symptoms should normally be evident for a year, though this can be shortened for severe cases.
So is this a disorder? In the UK, the NHS considers it as a condition that can affect mental health, with a recommended pathway of assessment for those who experience distress or disruption due to gambling. The Gambling Commission defines problem gambling in impairment terms: when it disrupts family, personal or recreational pursuits. A DSM-5 diagnosis requires 4 or more criteria.
A disorder is a diagnosable condition that deserves treatment, not a moral failing A survey found 0.4% of adults had a PGSI score of 8+, showing how even a small percentage of the population can be affected by gambling as a mental health issue.
But whatever it's called, it's a disorder that deserves treatment Put simply, if gambling is impairing your life, it's a disorder. However it's classified, it's not a good habit or a Thatcherite trade-off. It's about how the amounts increase, the time you spend, and the negative consequences, all underlined by psychological distress.
If gambling is causing issues that you struggle to control, the NHS says the first step is to assess the harm using their online questionnaire. This is an opportunity, not a judgement - it's a chance to start taking back the reins.
From there, assessment and potential treatment may be offered. It's not a label, it's a roadmap out. Your mental healthcare and treatment, including referrals, are there to help you. You return to take that step.
The National Gambling Helpline is free and confidential, open 24 hours a day: 0808 8020 133. More options on our help page.
