Estimated reading time: 4 minutes
Raghav’s Story
Rohini* is a 43-year-old first-generation Indian immigrant to the United States who moved to Las Vegas with her husband, Raghav*, and son, Rahul*, 5 years ago. Raghav is an IT professional, and she is a homemaker. Their son goes to a local public middle school.
For the past year, Raghav has been spending a lot of time and money on gambling. He has won some money a few times, but mostly lost money. He always tells Rohini that he will win big next time and is preoccupied with gambling in local casinos. Sometimes he has started making excuses to take absences from work and lying to Rohini. Rohini, worried, approached us for advice.
*Names changed upon request
Q: Could this be a gambling addiction?
Dr. Sharma: Rohini, Raghav is showing signs of compulsive gambling or a gambling disorder. This condition is characterized by a persistent urge to gamble despite distress or other negative outcomes, a preoccupation with gambling, trying to make up for losses, trying to conceal the gambling habit, and persisting despite having adverse consequences on job and relationships. Roughly 0.5% of the adult population in the United States suffers from this disorder. It is a type of behavioral addiction characterized by continual, repeated gambling that causes significant impairment in a person’s life, including financial, professional, psychological, and/or social problems.
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the previously used term pathological gambling was renamed as “gambling disorder” and included in the Substance-Related and Addiction Disorders chapter to emphasize that research suggests that gambling disorder and alcohol and drug addiction are related.
Q: What could have caused this addiction?
Dr. Sharma: The causation and risk factors of gambling disorder are complex, with both genetic and environmental factors playing a role. It is associated with stress, depression, domestic violence, substance use, financial losses, even bankruptcy, and high suicide rates. Impulsivity also plays a significant role in this addiction. Also, a poor diet and sedentary lifestyle are contributing factors to this condition.
In Raghav’s case, being in Las Vegas, where casinos are ubiquitous, may have also played a role. Some studies also showed that during the COVID-19 lockdown, online gambling disorders increased.
Q: What are the treatment options?
Dr. Sharma: There is a National Problem Gambling Helpline: 1-800-522-4700 for confidential support. However, you should encourage Raghav to consult a mental healthcare provider. Cognitive behavioral therapy (CBT), in which unhealthy thought and behavior patterns are identified and changed, is a useful approach. Motivational interviewing (MI) is also useful, which builds commitment and confidence to change.
Both of you may also consider family therapy, which will improve your relationships. A psychiatrist may be able to prescribe some medications, especially to treat any coexisting comorbidities. Support groups like Gamblers Anonymous that have a 12-step program are useful adjuncts to recovery. Finally, for severe cases, residential treatment options in a structured environment may be recommended.
Q: What are the signs of recovery from gambling addiction?
Dr. Sharma: A research study found four core features of recovery, namely, better insight, empowerment and commitment, enhancement of well-being, and reduced relapse. In other words, you will notice:
- Behavioral signs such as reduced or eliminated gambling, improved impulse control, and avoidance of high-risk situations.
- Then you will notice positive emotional signs, such as less preoccupation with gambling.
- Third is improved mood, reduced irritability, and a greater sense of self-awareness in Raghav, and
- Finally, you will notice improved social relationships, financial stability, and enhanced coping strategies.
Q: How can we prevent a relapse?
Dr. Sharma: That is an excellent question, Rohini, as relapse prevention is paramount. You both must be vigilant of internal and external triggers and nip them in the bud. He could keep a journal or a diary in this regard, which he can share with you. Raghav must develop healthy coping skills such as relaxation, hobbies, exercise, or creative activities. Both of you must build a solid social network of friends and support systems.
Raghav should be transparent about his finances and establish boundaries with your full knowledge. Finally, removing access to gambling and having an action plan in case he relapses will be very important.
Q: Can yoga and meditation help with gambling disorders?
Dr. Sharma: Yes, yoga and meditation support recovery by reducing stress and anxiety, improving emotional regulation, enhancing mindfulness and self-awareness, and promoting physical well-being, which contributes to enhanced resilience.
Q: Could you share some additional resources?
Dr. Sharma: Here are some additional resources from which you can find more information:
- Cleveland Clinic’s website on gambling disorder
- Gambling: How to regain control – from the Victoria State Government, Department of Health
- Mayo Clinic’s website on compulsive gambling
- Treatment recommendations for gambling disorders from Mass.gov
If you have questions, reach out to Dr. Manoj Sharma at editor@indiacurrents.com