When a little flutter becomes a lot of bother

If you are looking for a precise description, gambling can be defined as ‘placing something of value at risk in the hopes of gaining something of greater value’. Throughout history, we have evolved this into a number of legal and socially acceptable activities such as betting on animals (e.g. horses and greyhounds) and humans (e.g. footballers) in sporting competitions, cards, roulette wheels, slot machines and other casino games.

A fun hobby can spiral into an all-consuming preoccupation “Where this can start out as a fun hobby in which the thing of value put at risk is a chosen sum of money (e.g. £100 for the chance of winning £1000), gambling can spiral into an all-consuming preoccupation in which the risked things of value become your relationships, house, job, and ability to function without gambling. For some people, quitting is an easy decision when faced with risks that become too high, but others cannot seem to stop gambling, even when they know it would be the best thing for their wellbeing, as well as for that of their family and friends. The ‘rush’ of the risk, and of winning, is seemingly too much to resist.

Various biological explanations have been offered to explain these individual differences in predisposition to problem gambling. Evidence has shown that problem gamblers have lower levels of noradrenaline in their brains than other gamblers and controls. Because noradrenaline is a hormone and chemical messenger in the brain that is secreted in response to stress, arousal or thrill (the famed adrenaline rush), it has been proposed that these people seek the high of noradrenaline that risk-based activities like gambling offer in an effort to make up for their lower baseline levels.

It has also been suggested that people with less neural serotonin (the chemical messenger that contributes to feelings of happiness and wellbeing) are more likely to seek this feeling from gambling wins. Low serotonin is thought to play a role in depression (with most antidepressant medications acting to raise the brains levels of serotonin in some way), and this may be why many studies have found that gambling and depression are associated. This is not just because losing persistently when gambling takes a negative emotional toll. The internet makes gambling extremely accessibleFor example, one particular study at John Hopkins School of Public Health found that depressive symptoms in early adolescence were strongly associated with problem gambling in late adolescence i.e. it seems that depression can be an underlying problem of which gambling behaviour is a symptom: a form of self-medication that even the person themselves may not recognise.

Also important is dopamine, which signals reward. One study recently found that more dopamine was actually released in areas of problem gambler’s brains in response to ‘near misses’ than actual wins. This, combined with a tendency to view certain failures as ‘near misses’ rather than failures may be a reason why problem gamblers have such a hard time disengaging from gambling, even when they’re on a losing streak.

With the increased availability of the internet, and of gambling websites, gambling is becoming a harder activity for (biologically and economically) vulnerable people to resist, and so problem gambling is on the rise. Online bingo adverts are now ubiquitous in the ad breaks on TV, always cheery in nature and promoting their offer as a bit of harmless fun. They seem overtly gendered towards women, and women are heeding their call. So much so that the National Centre or Social Research recently expressed their concerns to parliament: “We see more women and older people becoming involved with gambling and an increase in the proportion of people who gamble regularly.” One woman commenting on a gambling addiction forum said it was precisely the online nature that got her into troubled waters, “It’s like it’s not even real money it’s just numbers on a screen. Before I know it, I’ve spent loads.”

Gambling isn’t just booming in cyber space: it’s re-defining the face of the high street, particularly in poverty-stricken areas. The post-recession town centres are already marked by vacant shop spaces freed up by small independents and larger retail outlets alike that couldn’t weather the financial storm, or which moved into out of town shopping centres.Bookmakers have swooped in to fill these gaps. Mary Portas was commissioned recently by the government to analyse the state of the nation’s retail and how it can be improved: one of her recommendations was to put tighter controls on how many betting shops can open up on high streets, especially in areas of high unemployment in which people may be more tempted by a the promise of a ‘big win’. Over £5bn was gambled in economically depressed towns last year, compared to just £44m in the areas with the lowest unemployment.

What support is out there for the growing numbers of people struggling with out of control gambling habits? Many people rely on the NHS and will report their problem to their general practitioner, but as Clare Gerada, Chair of the Royal College of GPs herself observed, “It is likely that even where primary health practitioners do identify the existence of a gambling-related harm, they regard this as a personal or ‘social’ problem, rather than a health issue [which would fall under their remit], meaning that the needs of relevant individuals are largely unaddressed.”

The other big option is something like Gambler’s Anonymous, but its requirement that attendees share information about themselves and their deepest struggles with strangers is not suited to everybody. Though the solidarity of experience with others who are struggling can be a comfort, group work is not the only means of finding this. Many psychotherapists who choose to specialize in helping people overcome problems with addictive behaviours do so because they have personal experience of this. Here at The House Partnership, we favour one to one therapy tailored to the specific needs and circumstances of each person.

The House Partnership, 23rd March 2013