Impulse Control Disorders Pathological Gambling

The prominent feature of impulse control disorders is the repeatedly inability to stop behaving impulsively, or to resist the desire for short term satisfaction from behaviors and actions that result in great long term loss or harm. Pathological gambling develops earlier in males than in females, probably because of the laws that limit legal gambling to adults. Males have more access to situations where informal and under aged gambling goes on.

There is some form of pleasure or tension relief from the behavior, even when the behavior is disfiguring or painful. There is tension before the act of compulsion and there is either pleasure or relief afterward. With gambling, however, there is often no “afterward”, as the process is a continuous one which can go on for as long as the individual has the money to pay.

As a result, pathological gambling is viewed as both an impulse disorder and a behavioral addiction where the hoped for emotional “high” is different than the guaranteed euphoria from drugs or alcohol addictions.

With pathological gambling, the short term relief of tension results in grave long term financial and often personal harm from dealing with unsavory people and situations. The inability to stop the behavior of gambling money that is needed for life essential needs, or that is borrowed in a way that cannot be repaid is repeated again and again, despite the obvious consequences.

Measuring the difference between recreational and pathological gambling can be done by comparing the impact on life, including financial disaster, bankruptcy, committing theft or embezzlement to cover gambling losses. Gambling as part of a manic episode is excluded from the definition of pathological gambling, which is a maladptive behavior.

Depression is a factor that relates to pathological gambling. To relieve the symptoms of depression, however,individuals can develop a fixation on the intermittent and random rewards that happen in gambling, expecting to eventually win money back by continuing in the activity, where at any time, a big payout can happen.  

In addition, the social and entertainment aspects of the casino or card room and the thrill of a risk taking adventure. Individuals who have been well controlled recreational gamblers can develop pathological gambling addictions as the result of life changing trauma or stresses or the onset of depression.

There is no known biological cause for the disorder, but there are some commonalities, such as depression, the risk taking and other mood altering aspects that become addictive. Others who have a history of superstitious belief systems or a cultural acceptance of gambling may develop the disorder.

The symptoms include lying about the extent of the gambling, short temper or irritability when having to stop, repeated failure to stop, and financial, work and other problems related to the activity.

Treatment includes aversion therapy, psycho dynamic therapy and twelve step programs that have worked for highly motivated patients.