Compulsive gambling

If you recognize that you may have a problem with gambling, talk with your health care provider about an evaluation or seek help from a mental health professional.

To evaluate your problem with gambling, your health care provider or mental health provider will likely:

• Ask questions related to your gambling habits. Your provider may also ask for permission to speak with family members or friends. However, confidentiality laws prevent your provider from giving out any information about you without your consent.
• Review your medical information. Some drugs can have a rare side effect that results in compulsive behaviors, including gambling, in some people. A physical exam may identify problems with your health that are sometimes associated with compulsive gambling.
• Do a mental health assessment. This assessment includes questions about your symptoms, thoughts, feelings and behavior patterns related to your gambling. Depending on your signs and symptoms, you may be evaluated for mental health disorders that are sometimes related to excessive gambling.

Treating compulsive gambling can be challenging. That's partly because most people have a hard time admitting they have a problem. Yet a major part of treatment is working on acknowledging that you're a compulsive gambler.

If your family or your employer pressured you into therapy, you may find yourself resisting treatment. But treating a gambling problem can help you regain a sense of control — and possibly help heal damaged relationships or finances.

Treatment for compulsive gambling may include these approaches:

• Therapy. Behavioral therapy or cognitive behavioral therapy may be helpful. Behavioral therapy uses a process of exposure to the behavior you want to unlearn and teaches you skills to reduce your urge to gamble. Cognitive behavioral therapy focuses on identifying unhealthy, irrational and negative beliefs and replacing them with healthy, positive ones. Family therapy also may be helpful.
• Medications. Antidepressants and mood stabilizers may help treat problems that often go along with compulsive gambling — such as bipolar disorder, depression or anxiety. Some antidepressants may be effective in reducing gambling behavior. Medications called narcotic antagonists, useful in treating substance misuse, may help treat compulsive gambling.
• Self-help groups. Some people find that talking with others who have a gambling problem may be a helpful part of treatment. Ask your health care provider or mental health provider for advice on self-help groups, such as Gamblers Anonymous and other resources.

Treatment for compulsive gambling may involve an outpatient program, inpatient program or a residential treatment program, depending on your needs and resources. Self-help treatments such as structured internet-based programs and telephone visits with a mental health professional may be an option for some people.

Treatment for substance misuse, depression, anxiety or any other mental health issue may be part of your treatment plan for compulsive gambling.

Relapse prevention

Even with treatment, you may return to gambling, especially if you spend time with people who gamble or you're in gambling settings. If you feel that you'll start gambling again, contact your mental health provider or sponsor right away to prevent a relapse.

These recovery skills may help you to resist the urges of compulsive gambling

• Stay focused on your No. 1 goal: Not to gamble.
• Tell yourself it's too risky to gamble at all. One bet typically leads to another and another.
• Give yourself permission to ask for help, as sheer willpower isn't enough to overcome compulsive gambling. Ask a family member or friend to encourage you to follow your treatment plan.
• Recognize and then avoid situations that trigger your urge to bet.

Family members of people with a compulsive gambling problem may benefit from counseling, even if the gambler is unwilling to participate in therapy.

If you've decided to seek help for compulsive gambling, you've taken an important first step.

What you can do

Before your appointment, make a list of:

• All the feelings you're experiencing, even if they seem unrelated to your problem. Note what triggers your gambling, whether you've tried to resist the urge to gamble and the effect that gambling has had on your life.
• Key personal information, including any major stresses or recent life changes.
• All medications, vitamins, herbs or other supplements that you're taking, including the dosages.
• Other physical or mental health problems that you have and any treatments.
• Questions to ask your provider to make the most of your appointment time.

Questions to ask may include:

• What's the best approach to my gambling problem?
• What are other options to the primary approach that you're suggesting?
• Should I see a psychiatrist, psychologist, addiction counselor or other mental health professional?
• Will my insurance cover seeing these professionals?
• Can I get help as an outpatient or would I need inpatient treatment?
• Are there any brochures or other printed material that I can have?
• What websites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your health care provider or mental health provider will likely ask you several questions, such as:

• When did your gambling first start?
• How often do you gamble?
• How has gambling affected your life?
• Are your friends or family members worried about your gambling?
• When you gamble, how much do you typically put on the line?
• Have you tried to quit on your own? What happened when you did?
• Have you ever been treated for a gambling problem?
• Are you ready to get the treatment needed for your gambling problem?

To make the most of your appointment time, be ready to answer these questions and to provide an accurate picture of your gambling issues.