Gambling disorder: signs, causes and treatment

Key points

• Gambling disorder, or gambling addiction, is a health condition treated in the NHS, not a money problem or a character fault [3][5].
• Its features are preoccupation, staking more for the same feeling, chasing losses, concealment and continuing despite harm [10].
• Harm reaches past money into mental health, work and family life. NICE calls family and friends affected others, who can be supported too [1][2].
• NICE guideline NG248, published 28 January 2025, recommends routine questions about gambling, a validated assessment tool, and CBT delivered by psychologists or accredited CBT therapists [1].
• Free help includes the National Gambling Helpline on 0808 8020 133, 24/7, NHS clinics taking self-referrals, and GamStop, which blocks online gambling accounts [3][6][9].

What gambling disorder is

Gambling disorder, commonly called gambling addiction, is a pattern of gambling a person struggles to control and keeps up despite harm to their money, health, relationships or work. NICE defines it as gambling that causes harm, problems or distress to the person gambling or to those close to them [2].

If you need help now. Samaritans: call 116 123, free, 24/7. Shout: text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger. For gambling, the National Gambling Helpline is free on 0808 8020 133, 24/7 [3][7].

It is a behavioural addiction, an addiction to an activity rather than a substance. DSM-5 groups it with substance-related and addictive disorders, because it resembles substance addiction in presentation, brain basis and treatment [10]. ICD-11, the World Health Organization’s current classification, also lists gambling disorder, though the NHS in England still codes with ICD-10.

No agreed UK prevalence figure is given here, as estimates shift with the survey used. NICE notes stigma and fear of disclosure stop many people mentioning gambling [1].

Symptoms

Gambling disorder shows in thinking, behaviour and money [3][10].

Thinking and feeling:

• Preoccupation with past bets, the next one, or funding it [10].
• Restlessness or irritability when cutting down or stopping [10].

Behaviour:

• Needing larger stakes for the same feeling, a form of tolerance [3][10].
• Repeated failed attempts to cut down [10].
• Hiding statements, deleting apps, lying about time and money [10].

Money and consequences:

• Betting more than can be afforded, borrowing or selling belongings, missed bills, new debt [3].
• Damage to a relationship, job or course that the gambling outlasts [10].

Chasing losses is the engine of the harm. After a loss, gambling again feels like the quickest way back to level, so stakes rise and sessions lengthen. Each loss makes the sum needed to break even bigger, so the pull to carry on is strongest where stopping would limit the damage [3][10].

It is often mistaken for being bad with money or bad luck, and it overlaps with depression, anxiety and alcohol or drug use [1].

Types

Gambling disorder has no formally recognised subtypes. UK services describe severity bands and patterns of gambling instead.

• Severity. NICE treats gambling that harms as a spectrum, from lower severity suited to community support to complex cases needing a specialist clinic [1]. On the NHS nine-question self-assessment, 8 or higher means harms are likely [3].
• Online gambling, where the risk differs from betting shops or casinos. Apps are open at any hour, with nobody watching. Rounds repeat within seconds, so losses build faster than a person can take stock, and in-play betting offers a fresh market every few minutes of a live event. Online accounts are the ones GamStop blocks [9].
• Affected others: people harmed by the gambling of someone close to them [2].

Causes and risk factors

There is no single cause. Gambling disorder comes from a mix of the person, their circumstances and the design of the product, and NICE says several risk factors together raise risk [1].

• Existing mental health problems, or alcohol or drug use [1].
• Some prescribed medicines. NICE names aripiprazole and Parkinson’s disease medicines as examples to review [1]. Any change is the prescriber’s decision.
• Neurological conditions, or new independence such as managing money for the first time [1].
• A high-risk occupation, financial pressure, or safeguarding concerns [1].
• Exposure to gambling advertising, which NG248 treats as a relapse trigger to plan for [1].

The explanations the evidence does not support are greed, weak willpower and bad character. Gambling was reclassified as an addictive disorder because it resembles substance addiction, not from any judgement about the person [10].

How it is diagnosed

NHS gambling treatment services, run by NHS and voluntary sector organisations, assess gambling disorder, and GPs and mental health teams screen for it and refer on [1][3]. NICE says people should also be told they can self-refer, through an NHS triage service or the helpline [1].

Assessment usually involves:

• a validated tool, such as the Problem Gambling Severity Index or South Oaks Gambling Screen [1];
• a conversation covering gambling history, frequency, mental and physical health, suicide risk and financial impact [1];
• a check on whether current medicines may be contributing [1];
• a case formulation, care plan and, if needed, a safety plan agreed with the person [1].

No reliable national waiting time figure is published. A diagnosis names a pattern of behaviour and its harms, and opens a route into treatment. NICE notes severity varies over time, so even a short recent period of gambling can cause severe harm [1].

Treatment

NICE guideline NG248 sets out how treatment for gambling-related harms should be organised and delivered [1].

• Talking therapy. NICE states that cognitive behavioural therapy, CBT, should be delivered by psychologists or accredited CBT therapists [1]. CBT examines the thoughts and situations that lead to a bet and builds ways to interrupt them.
• Service structure. Services should include specialist provision for complex needs, alongside support for lower severity [1].
• Prompt access. NICE recommends non-judgemental approaches, fewer barriers to entry, and starting treatment promptly [1].
• Relapse. NICE treats relapse as part of the condition, not failure, and recommends prevention skills, follow-up and rapid re-entry to treatment [1].
• Affected others. NICE recommends supporting family and friends alone, or jointly with the person gambling if both agree, covering their own distress and needs [1][4].
• Medication. NG248 centres on assessment, access and psychological treatment rather than drug treatment [1]. Do not start or stop any medicine without speaking to the prescriber.

NHS England says its commissioning covers referral through to aftercare [5]. GamCare provides free counselling by phone, live chat, WhatsApp and email, plus peer support alongside Gamblers Anonymous [3][6][7]. GambleAware offers advice and a local support finder [8].

Living with gambling disorder

Control of money and access usually has to run alongside treatment.

• Block access. GamStop Online stops you using online gambling sites and apps from six months up to five years, and software such as Gamban blocks gambling on your devices [3][9].
• Turn on a bank gambling block, offered in many UK banking apps, which declines payments to gambling firms. GamCare can also help with finances [6].
• Deal with debt rather than ignoring it: the NHS points people to National Debtline [3]. Debt advice is separate from treatment, and you can use both.
• If someone else’s gambling affects you, you can get help without them being in treatment. The NHS lists GamAnon, GamFam and Gambling with Lives, which supports people bereaved by gambling-related suicide [3]. The helpline takes calls from family and friends [7].
• Telling an employer or university is your choice, and a short note about any adjustment you need is usually enough.

When to speak to a professional

Speak to your GP, contact an NHS gambling clinic, or call the National Gambling Helpline on 0808 8020 133 if any of these apply to you or someone close [3][7].

• Gambling more than you can afford to lose, or borrowing to fund it.
• Chasing losses, or needing bigger stakes to feel the same.
• Trying to stop and finding you cannot.
• Hiding gambling, or lying about money.
• Debt building, bills unpaid, post unopened.
• Mood, sleep, work or relationships worsening alongside gambling.

Get help immediately if you or someone else has thoughts of suicide or self-harm. Call Samaritans free on 116 123, text SHOUT to 85258, or call 999 if anyone is in immediate danger. Suicide risk is part of gambling assessment in the UK, and the NHS signposts support for people bereaved by gambling-related suicide [1][3].

Common questions

What does chasing losses mean?

Chasing losses means gambling again to try to win back money already lost [3]. It raises stakes and lengthens sessions, so the sum needed to break even grows, and it is one of the questions used in NHS screening [3].

Does GamStop stop all gambling?

No. GamStop blocks accounts with participating online gambling companies from six months up to five years [9]. GamStop Online covers online accounts only, not betting shops or firms outside the scheme. GamStop runs a separate service, GamStop Betting Shops, for high street bookmakers. Many people also add blocking software and a bank block [3][9].

Can I get help if it is my partner or relative who gambles?

Yes. NICE calls you an affected other and recommends that services offer you support, alone or jointly with the person gambling if you both agree [1][2]. The helpline is for anyone affected by gambling harms [7].

Clinical review pending

References

1. National Institute for Health and Care Excellence. Gambling-related harms: identification, assessment and management. NICE guideline NG248, published 28 January 2025. https://www.nice.org.uk/guidance/ng248/chapter/Recommendations
2. National Institute for Health and Care Excellence. Terms used in this guideline. NICE guideline NG248, 2025. https://www.nice.org.uk/guidance/ng248/chapter/Terms-used-in-this-guideline
3. NHS. Gambling addiction. NHS website. https://www.nhs.uk/live-well/addiction-support/gambling-addiction/
4. National Institute for Health and Care Excellence. Information for the public. NICE guideline NG248, 2025. https://www.nice.org.uk/guidance/ng248/informationforpublic
5. NHS England. Gambling harms services. NHS England. https://www.england.nhs.uk/mental-health/gambling/
6. GamCare. Get support. GamCare. https://www.gamcare.org.uk/get-support/
7. GamCare. National Gambling Helpline. GamCare. https://www.gamcare.org.uk/
8. GambleAware. Free advice, tools and support. GambleAware. https://www.gambleaware.org/
9. GamStop. The National Online Self Exclusion Scheme. GamStop. https://www.gamstop.co.uk/
10. American Psychiatric Association. What Is Gambling Disorder? APA. https://www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder