Pathological gambling is being unable to resist impulses to gamble, which can lead to severe personal or social consequences.

Gambling - compulsive; Compulsive gambling; Addictive gambling

Pathological gambling usually begins in early adolescence in men, and between ages 20 and 40 in women. It is more common in adults living within 50 miles of a casino.

Pathological gambling is a brain disease that seems to be similar to disorders such as alcoholism and drug addiction. These disorders likely involve problems with the part of the brain involved with behaviors such as eating and sex. This part of the brain is sometimes called the "pleasure center" or dopamine reward pathway.

In people who develop pathological gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.

People with pathological gambling often feel ashamed and try to avoid letting others know of their problem. The American Psychiatric Association defines pathological gambling as having 5 or more of the following symptoms:

• Spending a lot of time thinking about gambling, such as past experiences or ways to get more money with which to gamble
• Needing to gamble larger amounts of money in order to feel excitement
• Having had many unsuccessful attempts to cut back or quit gambling
• Feeling restless or irritable when trying to cut back or quit gambling
• Gambling to escape problems or feelings of sadness or anxiety
• Gambling larger amounts of money to try to make back previous losses
• Lying about the amount of time or money spent gambling
• Committing crimes to get money to gamble
• Losing a job, relationship, or educational or career opportunity due to gambling
• Needing to borrow money to get by due to gambling losses

A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions can help with the diagnosis.