Gambling Disorder is a psychiatric condition in which the individual engages in repetitive and uncontrolled gambling behavior, seriously impairing social, occupational and financial functioning. In DSM-5, it is classified within the addiction spectrum alongside substance use disorders. This classification highlights that gambling behavior should not be considered merely as a weakness of will but as a serious disorder with neurobiological and psychosocial foundations. Gambling disorder typically begins in young adulthood and may follow a chronic course if left untreated.

DSM-5 Diagnostic Criteria for Gambling Disorder

According to the American Psychiatric Association’s DSM-5, a diagnosis of gambling disorder requires that at least four of the following criteria be met within the past 12 months:

• A need to gamble with increasing amounts of money to achieve the desired level of excitement
• Restlessness or irritability when attempting to cut down or stop gambling
• Repeated unsuccessful efforts to control, cut back or stop gambling
• Being preoccupied with gambling (e.g., reliving past experiences, planning the next venture)
• Gambling when feeling distressed
• Returning another day to get even after losing money (chasing losses)
• Lying to conceal the extent of involvement with gambling
• Jeopardizing or losing significant relationships, job or educational opportunities due to gambling
• Relying on others to provide money to relieve desperate financial situations caused by gambling

The behavior must cause clinically significant impairment in important areas of functioning.

Symptoms of Gambling Disorder

Commonly observed symptoms include:

• Loss of Control: Continuing to gamble despite awareness of mounting losses
• Obsessive Thoughts: Gambling-related thoughts dominating daily life
• Financial Problems: Borrowing money, taking out loans or spending savings on gambling
• Family Conflicts: Loss of trust, lies and communication breakdowns in close relationships
• Mood Changes: Experiencing excitement during gambling, followed by guilt, depression and hopelessness

Causes of Gambling Disorder

The etiology is multifactorial, involving genetic, neurobiological and environmental influences:

• Genetic Predisposition: Family history of addiction increases risk; dopamine system variations are linked to reward expectation and impulse control (Potenza, 2008).
• Neurobiological Factors: Prefrontal cortex dysfunction and dopamine-serotonin imbalances impair decision-making (Grant & Kim, 2003).
• Childhood Trauma: Neglect, abuse or emotional deprivation may increase vulnerability.
• Accessibility and Environmental Factors: Easy access to gambling venues or online betting increases risk.

Risk Factors

• Male gender
• Early onset of gambling
• Co-occurring substance use disorders
• Depression, bipolar disorder or anxiety disorders
• Impulsivity and low self-control
• Family dysfunction and social isolation

For some individuals, gambling functions as an emotional escape strategy, pointing to psychological underpinnings of the disorder.

Diagnosis of Gambling Disorder

The diagnostic process involves a detailed clinical interview evaluating:

• Frequency and duration of gambling behavior
• Extent of financial losses
• Impact on relationships and overall functioning
• Presence of comorbid psychiatric conditions or substance use

In addition to DSM-5 criteria, assessment tools such as the Problem Gambling Severity Index (PGSI) or South Oaks Gambling Screen (SOGS) can be used. Neuropsychological tests and toxicology screenings may be conducted when necessary.

Treatment of Gambling Disorder

Treatment is multidimensional and tailored to the individual’s clinical status:

1. Psychotherapy

• Cognitive Behavioral Therapy (CBT): Targets faulty gambling-related beliefs such as “I am due to win” or “luck will change.”
• Motivational Interviewing: Aims to enhance intrinsic motivation for change.
• Group Therapy: Support groups such as Gamblers Anonymous provide social support and awareness.

2. Pharmacotherapy

• SSRIs (e.g., fluoxetine): Used particularly when depression or anxiety is present.
• Naltrexone: An opioid antagonist that may reduce gambling urges by acting on the reward system (Grant et al., 2006).
• Antiepileptics such as topiramate: May help reduce impulsivity.

Medication must be individualized and considered alongside comorbid psychiatric diagnoses.

3. Family and Social Support

Psychoeducation of family members, crisis management, financial boundary setting and support with debts can positively influence treatment outcomes.

4. Online and Mobile Interventions

Digital CBT programs and real-time support services may be especially beneficial in early stages.

Impact on Daily Life

The disorder can have devastating consequences across all life domains:

• Financial Ruin: Debts, credit overuse and bankruptcy
• Relationship Problems: Family trust breakdown, divorce, conflict with children
• Occupational and Educational Impact: Absenteeism, decreased performance, job loss
• Psychological Effects: Shame, guilt, helplessness and suicidal ideation

Studies indicate that 17–25% of individuals with gambling disorder develop suicidal thoughts, and 4–7% attempt suicide (APA, 2013).

Gambling disorder is not merely a behavioral problem but a serious psychiatric condition with biological, psychological and social dimensions. Early diagnosis and intervention can significantly improve quality of life. Therefore, raising awareness, improving treatment access and expanding preventive mental health services are crucial at both individual and societal levels.