Bet your life

Problem gambling feature DDN

According to the Gambling Commission, in the period from April 2022 to March 2023 the total gross yield of the British gambling industry was more than £15bn, £6.5bn of which came from remote (online/interactive TV) casinos, betting, and bingo. More than 22m people engaged in gambling activity and 90m bets were placed, with the Gambling Commission issuing around £60m in fines to operators last year.

You may be reading this and thinking, ‘what constitutes gambling?’ The Oxford dictionary definition is: ‘Play games of chance for money, bet’ and ‘Take risky action in the hope of a desired result’. Most people have gambled in their lifetime – the National Lottery, sweepstakes, tombola, scratch cards – and for most gambling is seen as a social, fun activity. However, for some people gambling can become harmful and have a significant impact on the individual, family, and wider society. It’s estimated that for every person who gambles, between six and ten others are affected – according to a 2020 House of Lords study, this equates to around 2m people harmed by the break-up of families, crime, loss of homes and ultimately loss of life.

Gambling DDN

So where does it start? How do some people become addicted, and some people don’t? Taking risks is part of human nature – we take risks every day, be it placing a bet or riding a bike. A surprising or unexpected reward causes an extra dopamine rush, activating the brain’s reward system. Some gamblers talk about experiencing ‘the rush’ of their first win – this is the reward system being activated, and to experience these feelings again there may be a desire from the person to gamble repeatedly.

Over time the brain becomes more resistant to dopamine, so a person may bet higher stakes to make it more exciting in the same way that someone may seek higher doses of a drug to experience the same high. Gambling disorder is a recognised diagnosis in the DSM-5-TR classification of mental health disorders, while the other tool used to help people identify if they have a gambling disorder is the PGSI score. This is a standardised measure of at-risk behaviour, based on the common signs and consequences of gambling. The tool can help someone make an informed decision on what steps to take next.

It’s recognised that some forms of gambling are more addictive than others, such as online slots and online casino games, but all forms of gambling carry a level of risk and can be harmful. The product design of online games – namely their speed and frequency – increases the risk of a person becoming addicted. Some of these can be played every 2.5 seconds, which is much faster than if the person was playing in a casino or on a slot machine. Players can also place multiple bets on a single game or event, which provides more opportunities to gamble within a shorter period.

Many online games such as slots and casino games have unlimited stakes, so when combined with high speed of play it’s possible to risk large amounts of money in a very short period. There is evidence that higher stake limits are linked to higher rates of harm.

Problem gambling devastating effects

The impacts of gambling-related harms can vary from person to person and can be found in isolation or alongside other issues. Whilst many people associate gambling harms with financial distress, such as loss of earnings and debt, there are several other harms that should be considered. These include mental and physical harms, relationship harms, criminal activity and cultural harms.

Over the last two years, Adferiad have been piloting a treatment pathway for people experiencing complex co-morbidities and gambling-related harms. To date we’ve received more than 255 referrals and treated over 150 people. The majority of those treated required a detox, with substances ranging from alcohol, cannabis and ketamine to cocaine, crack cocaine and heroin. This pathway is groundbreaking and offers people the chance of a seamless treatment pathway to help address their co-morbidities and gambling addiction.


The relationship between gambling and mental health problems is complex and bidirectional, meaning that mental health issues can lead to problem gambling and vice versa. Here are some key points on how gambling harms are connected to mental health:

Problem gambling is strongly linked to depression and anxiety disorders. The stress and financial strain caused by gambling losses can exacerbate feelings of hopelessness and anxiety. Conversely, individuals with depression or anxiety may turn to gambling as a form of escape or to cope with their symptoms, creating a harmful cycle.

There’s a significant overlap between gambling addiction and substance use disorders. Individuals with gambling problems often have higher rates of alcohol and/or drug use. This comorbidity can worsen the overall impact on mental health, and make treatment more challenging.

Gambling addiction is associated with an increased risk of suicidal thoughts and behaviours. The financial devastation and associated feelings of guilt and shame can lead to severe emotional distress, making some individ­uals feel that suicide is the only way out. According to a Swedish study from 2018, individuals affected by gambling-related harms are up to 15 times more at risk of suicide than the general population.

Chronic stress is a common consequence of problem gambling. The continuous worry about debts, hiding the addiction from loved ones and the frequent highs and lows associated with gambling wins and losses contribute to a high-stress environment. This chronic stress can lead to other mental health problems, including severe anxiety and panic disorders.

The social consequences of gambling can also affect mental health. Relationships with family and friends often deteriorate due to the behaviours associated with gambling addiction, such as lying, borrowing money, or neglecting responsibilities. This social isolation can further contribute to feelings of loneliness and depression.

Gambling disorder itself is classified as an impulse control disorder. People with this disorder often exhibit poor impulse control, which can also manifest in other areas of life, leading to a broader spectrum of mental health issues.

Cheryl Williams is strategic lead of gambling-related and other harms at Adferiad

Adferiad is part of the National Gambling Support Network (NGSN), a network of providers that offer free and confidential treatment and support for people who are experiencing gambling harms. Contact:

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