Quick Answer

Gambling disorder is the official medical diagnosis for gambling addiction, defined in the DSM-5 as "persistent and recurrent problematic gambling behavior" causing significant impairment. To be diagnosed, a person must meet 4 or more of 9 criteria within 12 months. It affects 0.4-1.6% of adults globally and is classified as an addictive disorder, alongside substance use disorders.

Official Medical Definition

Gambling disorder is the clinical term recognized by the American Psychiatric Association (APA) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

DSM-5 Definition

"Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period..." (APA, 2013)

ICD-10 Classification

The World Health Organization's International Classification of Diseases (ICD-10) uses the term "Pathological Gambling" with code F63.0 under "Habit and Impulse Disorders."

The upcoming ICD-11 reclassifies it as "Gambling Disorder" (code 6C50) under "Disorders due to Addictive Behaviors," aligning with the DSM-5's addiction classification.

The DSM-5 Diagnostic Criteria

A mental health professional diagnoses gambling disorder when someone exhibits 4 or more of these symptoms in a 12-month period:

1. Tolerance

Needs to gamble with increasing amounts of money to achieve the desired excitement.

Example: Started betting $10 per game, now needs $100+ bets to feel the same rush.

2. Withdrawal

Restless or irritable when attempting to cut down or stop gambling.

Example: Becomes agitated, anxious, or depressed when unable to gamble; experiences physical symptoms like sweating or insomnia.

3. Loss of Control

Repeated unsuccessful efforts to control, cut back, or stop gambling.

Example: Says "I'll just bet $50" but can't stop until all money is gone; makes rules ("only weekends") but breaks them repeatedly.

4. Preoccupation

Often preoccupied with gambling (reliving past experiences, planning next ventures, thinking of ways to get money for gambling).

Example: Constantly checking odds, watching gambling streams, daydreaming about winning; gambling thoughts interfere with work and relationships.

5. Escape Gambling

Often gambles when feeling distressed (helpless, guilty, anxious, depressed).

Example: Uses gambling to escape depression, anxiety, relationship problems, or work stress rather than for entertainment.

6. Chasing Losses

After losing money gambling, often returns another day to get even ("chasing" one's losses).

Example: Loses $500 on Monday, returns Tuesday determined to "win it back"; escalating pattern of trying to recover losses.

7. Lying

Lies to conceal the extent of involvement with gambling.

Example: Hides gambling activity from family; lies about time spent gambling; conceals financial losses; creates false explanations for missing money.

8. Relationship/Career Impact

Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.

Example: Spouse threatens divorce; fired for gambling at work; missed graduation due to gambling; lost business due to neglect.

9. Bailout

Relies on others to provide money to relieve desperate financial situations caused by gambling.

Example: Asks family for loans to cover rent after gambling losses; relies on credit cards or payday loans; asks for "bailouts" repeatedly.

Severity Levels

The DSM-5 classifies gambling disorder into three severity levels based on the number of criteria met:

Severity	Criteria Met	Description
Mild	4-5 symptoms	Early-stage disorder; problems beginning to emerge
Moderate	6-7 symptoms	Significant impairment; clear negative consequences
Severe	8-9 symptoms	Extreme impairment; devastating consequences

Important: Someone with "mild" gambling disorder still has a clinical diagnosis requiring treatment. "Mild" doesn't mean the problem is insignificant—it means early intervention can prevent progression to severe disorder.

Prevalence & Statistics

Global Prevalence

0.4-1.6% of adults worldwide have gambling disorder (Calado & Griffiths, 2016)
2-3% have subclinical problem gambling (2-3 symptoms)
Men are 2-3 times more likely to be diagnosed than women

United States

2.5 million U.S. adults (1%) meet criteria for gambling disorder (NCPG, 2024)
An additional 5-8 million adults (2-3%) have problem gambling
Only 10% seek treatment - lowest treatment-seeking rate of any addiction

Recent Surge: Online & Sports Betting

Since the 2018 legalization of sports betting:

30% increase in gambling disorder rates in states that legalized (UC San Diego, 2024)
68% of online sports bettors show at least one sign of gambling problems
Fastest-growing addiction among young adults (18-29)

Gambling Disorder vs. Other Diagnoses

Gambling Disorder vs. Problem Gambling

Gambling Disorder	Problem Gambling
Clinical diagnosis (DSM-5)	Descriptive term, not a diagnosis
Requires 4+ criteria	Any negative gambling consequences
Diagnosed by mental health professional	Self-identified or screening-identified
Severe, persistent pattern	Can range from mild to severe

Think of it this way: All gambling disorder is problem gambling, but not all problem gambling meets criteria for gambling disorder.

Gambling Disorder vs. Substance Use Disorder

Gambling disorder shares more similarities with substance addictions than differences:

Similarities
Activates same brain reward pathways
Causes dopamine dysregulation
Involves tolerance and withdrawal
Genetic vulnerability factors overlap
Similar treatment approaches work
High relapse rates without treatment

Key Difference
No ingested substance - behavioral addiction only

This is why DSM-5 moved gambling disorder to the "Substance-Related and Addictive Disorders" chapter—the first behavioral addiction officially recognized in this category.

Co-Occurring Disorders

Gambling disorder rarely occurs alone. Research shows high rates of co-occurring mental health and substance use disorders:

Common Co-Occurring Conditions

Depression: 38% of people with gambling disorder (Lorains et al., 2011)
Anxiety Disorders: 37%
Alcohol Use Disorder: 73%
Drug Use Disorders: 38%
ADHD: Significantly elevated rates
Personality Disorders: 60% (especially antisocial, borderline, narcissistic)

Which Comes First?

Research shows mixed patterns:

Some people gamble to self-medicate depression/anxiety (gambling comes second)
Others develop depression/anxiety as a consequence of gambling problems
Many have bidirectional relationships - each condition worsens the other

Treatment implication: Addressing co-occurring disorders simultaneously improves gambling disorder outcomes.

How Gambling Disorder is Diagnosed

Clinical Assessment Process

1. Structured Clinical Interview
Mental health professionals use standardized interviews to assess:

All 9 DSM-5 criteria
Onset, duration, and severity
Impact on functioning
Co-occurring disorders

2. Screening Tools
Common validated assessments:

SOGS (South Oaks Gambling Screen) - 20 questions
PGSI (Problem Gambling Severity Index) - 9 questions
NODS (NORC DSM-IV Screen) - maps directly to DSM criteria

3. Collateral Information
When possible, clinicians gather information from:

Family members or partners
Financial records
Legal documents (if applicable)

Differential Diagnosis

Clinicians must rule out:

Manic episodes (excessive gambling during mania in bipolar disorder)
Social gambling (recreational, no impairment)
Professional gambling (income source, calculated risks)

Treatment & Prognosis

The good news: Gambling disorder is highly treatable, especially when caught early.

Evidence-Based Treatments

1. Cognitive Behavioral Therapy (CBT)

Gold standard for gambling disorder
50-70% success rate at 1-year follow-up
Addresses cognitive distortions and develops coping skills

2. Medications (Off-Label)

Naltrexone: Reduces urges in 40-60% of patients
SSRIs: May help with co-occurring depression/anxiety
Not FDA-approved for gambling, but show promise

3. Mutual Support Groups

Gamblers Anonymous (GA) - free, 12-step model
SMART Recovery - science-based alternative

4. Brief Interventions

Motivational Interviewing effective for mild-moderate cases
Can be delivered in primary care settings

Recovery Outcomes

With treatment: 70-80% maintain abstinence or controlled gambling at 1 year
Without treatment: Only 10-30% achieve recovery on their own
Early intervention: Those who seek help at mild severity have best outcomes

Relapse Rates

First year is highest risk: 50-70% relapse within first year without ongoing support
Ongoing support reduces relapse: GA attendance or continued therapy lowers risk significantly
Relapse doesn't mean failure: Many people need multiple treatment attempts before sustained recovery

When to Seek Professional Help

You should consult a mental health professional if you:

Meet 4+ DSM-5 criteria (likely gambling disorder)
Have tried to stop on your own but can't
Experience suicidal thoughts related to gambling
Face legal or severe financial consequences
Have family/work relationships severely impacted

How to Get Diagnosed

1. Call the National Problem Gambling Helpline: 1-800-522-4700

Free, confidential, 24/7
Can provide referrals to local clinicians

2. See Your Primary Care Doctor

Can screen for gambling disorder
Refer to mental health specialist
Address physical health issues

3. Find a Gambling Disorder Specialist

NCPG Treatment Directory
Look for therapists trained in CBT for gambling
Check if your insurance covers gambling treatment

4. Self-Assessment

NCPG Online Screening
Not a diagnosis, but helps determine if professional evaluation needed

The Bottom Line

Gambling disorder is a legitimate medical diagnosis, not a character flaw or lack of willpower. It's a treatable brain disorder with:

✅ Clear diagnostic criteria
✅ Evidence-based treatments
✅ Good prognosis with early intervention
✅ Professional treatment resources available

If you think you might have gambling disorder, getting a professional diagnosis is the first step toward recovery. Don't wait for things to get worse—help is available today.

The earlier you seek help, the better your outcomes.

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
World Health Organization. (2018). International Classification of Diseases, 11th Revision (ICD-11). Geneva: WHO.
Calado, F., & Griffiths, M. D. (2016). Problem gambling worldwide: An update and systematic review. Journal of Behavioral Addictions, 5(4), 592-613.
National Council on Problem Gambling. (2024). NGAGE 3.0 Survey Results.
Lorains, F. K., et al. (2011). Prevalence of comorbid disorders in problem and pathological gambling. Journal of Gambling Studies, 27(1), 1-13.
Petry, N. M., et al. (2014). An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction, 109(9), 1399-1406.

What is Gambling Disorder? DSM-5 Diagnosis & Criteria