Substance-Related and Addictive Disorders
Gambling Disorder
Gambling Disorder is a persistent or repetitive pattern of gambling that becomes difficult to control and causes significant distress or problems in life. It is not defined by the amount one gambles or by one big loss, but by the relationship with gambling, the loss of control and the consequences on finances, relationships, work and safety.
It can be about casinos, agencies, online gambling, money games or any activity where something of value is risked with the expectation of profit. In the DSM-5-TR it is the only non-substance-related behavioural dependence included in the chapter of addictive disorders. Early help is valuable even before all diagnostic criteria are met.
What Is Gambling Disorder?
Gambling may begin as entertainment, but in the disorder it takes up more and more space and continues despite the negative consequences. The person may chase losses, conceal the extent of the involvement, or rely on others for financial rescue. The course often has periods of ups and downs, so a temporary break doesn't always mean the problem is solved. The diagnosis is not a moral judgement: it is a mental health condition that can affect people of all ages and social backgrounds.
Key Features and Signs
During the evaluation, the following criteria are considered, among others, within a period of 12 months:
- A need to gamble with increasing amounts of money to achieve the desired excitement.
- Restlessness or irritability when tapering or stopping is attempted.
- Repeated unsuccessful attempts to control, limit or stop gambling.
- Frequent thoughts about previous games, ways to find money or your next betting opportunity.
- Gambling when distressed, such as when feeling anxious, guilty, lonely, or depressed.
- Returning after losses with the aim of "recovering" the money, i.e. chasing the losses.
- Lying or concealing from family, therapists, or others about the extent of the involvement.
- Risk or loss of an important relationship, education, job or career opportunity due to gambling.
- Leaning on others for money to deal with financial crises caused by gambling.
How It Is Diagnosed
Diagnosis is made with confidential clinical assessment of behaviour, financial and family implications, mental health, substances and safety.
- At least 4 of the 9 characteristics are present during the same 12-month period.
- The pattern is persistent and repetitive and leads to clinically significant distress or impairment.
- The behaviour is not better explained by a manic episode, during which gambling may form part of a broader period of elevated or irritable mood, increased energy, and impulsivity.
- Current severity is mild when 4–5 criteria are met, moderate with 6–7 criteria, and severe with 8–9 criteria. The overall level of financial, relational, occupational, and safety-related harm is assessed separately.
- Debt, access to money, fraud or other illegal acts, risks to family safety and financial security, depression and suicidal risk are assessed promptly.
How It Can Affect Daily Life
Preoccupation with gambling reduces the time available for work, study, sleep and family.
Causes and Risk Factors
Previous losses do not make a future win more likely. Many commercial gambling products are designed with a mathematical advantage for the operator.
Similar or Co-occurring Conditions
Accurate differential diagnosis informs the care plan.
- During a manic episode, risky gambling occurs within a broader period of elevated or irritable mood, decreased need for sleep, and other symptoms of mania.
- Alcohol or other substance use disorders often co-occur and may exacerbate impulsivity, debt, and risk-taking.
- Depression, anxiety, and attention-deficit/hyperactivity disorder may pre-exist, co-occur, or be exacerbated by the effects of gambling.
- Occasional participation without loss of control and significant harm is not a disorder in itself, although it may have financial risk.
- Problem spending, video gaming, and other repetitive behaviours need a separate assessment and do not automatically equate to Gambling Disorder.
Treatment and Support
Effective care combines treatment, practical advice and support for consequences.
- Cognitive-behavioural therapy can work on impulses, chasing losses, false beliefs about probabilities, and relapse prevention.
- Motivational interviewing helps when there is ambivalence and can foster readiness to change without confrontation or shame.
- Self-exclusion from platforms and spaces, application blocking, transaction limits and temporary financial management by a trusted person can reduce access immediately, with clear consent and design.
- Debt counselling, checking accounts, and protecting money for housing, food, and children are a key part of recovery; new loans to cover losses usually make the cycle worse.
- Support groups and family support can reduce isolation. In Greece, the KETHEA hotline 1114 offers information and support for problem gambling.
- Do not self-medicate. Discuss medication options with an appropriate specialist.
When to Seek Help
Seek help when gambling is hidden, causes debt or conflict, is financed with money for basic needs, repeats after attempts to quit, or is used to escape strong emotions. Don't wait until all the money is gone. Threats from creditors, danger to children or partner, illegal acts, despair or suicidal thoughts need immediate evaluation and safety plan.
Frequently Asked Questions
How much money does one have to lose for there to be a disorder?
There is no specific monetary threshold. Diagnosis is based on the pattern of impaired control, the criteria met during the last 12 months, and the resulting distress or harm.
Can chasing losses help recover previous losses?
Restricting access to gambling and seeking debt or financial advice are safer steps than chasing losses.
How can the family help without covering the debts?
Family members can support treatment-seeking, protect money needed for basic family expenses, agree on transparent boundaries, and seek counselling for themselves. Repeated financial bailouts without a plan can maintain the cycle.
Is there a gambling helpline in Greece?
KETHEA helpline 1114 provides information and support for problem gambling. Because hours and services may change, check the current information on KETHEA's official website.