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Problem gambling is closely linked to mental health conditions like depression and anxiety. We explain the connection, common co-occurring conditions, and where to find support.
Problem gambling and mental health are closely linked. People with gambling problems often have co-occurring mental health conditions, and mental health conditions can increase the risk of developing gambling problems.
This guide explains the connection between gambling and mental health, common co-occurring conditions, and where to find support.
Research consistently shows that people with gambling problems are more likely to have mental health conditions, and vice versa. The relationship is bidirectional:
The financial, relational, and emotional impact of problem gambling can lead to:
• Depression
• Anxiety
• Stress
• Suicidal thoughts
• Substance use disorders
People with mental health conditions may use gambling as a way to cope:
• Depression: gambling for excitement or distraction
• Anxiety: gambling to escape anxious thoughts
• Trauma: gambling to numb painful feelings
• Loneliness: gambling for social connection
The bidirectional relationship means that treating gambling problems often requires addressing mental health, and vice versa.
The most common co-occurring condition with problem gambling:
• 60% of problem gamblers experience depression
• Depression can lead to gambling (escape) or result from gambling (financial loss)
• Symptoms: persistent sadness, loss of interest, sleep problems, fatigue, hopelessness
Gambling and depression create a cycle: depression leads to gambling, gambling losses worsen depression, leading to more gambling.
Anxiety is also strongly associated with problem gambling:
• 40% of problem gamblers experience anxiety
• Anxiety can lead to gambling (escape) or result from gambling (anticipatory stress about losses)
• Symptoms: excessive worry, restlessness, sleep problems, panic attacks
The uncertainty of gambling outcomes can worsen anxiety, particularly for players who fear losses.
Problem gambling is strongly associated with alcohol and drug use:
• 50% of problem gamblers have substance use issues
• Alcohol and gambling often co-occur
• Substances can lower inhibitions and increase gambling
Substance use during gambling is particularly risky. Impaired judgement can lead to larger bets and longer sessions.
Problem gambling is common among people with PTSD:
• Trauma history is a risk factor for problem gambling
• Gambling can be a way to numb traumatic memories
• Trauma and gambling create a cycle that's hard to break
For people with trauma history, gambling can feel like a safe escape. But it typically makes things worse.
Some personality disorders are associated with higher problem gambling rates:
• Borderline personality disorder (impulsivity, emotional dysregulation)
• Antisocial personality disorder (risk-taking, disregard for consequences)
• Narcissistic personality disorder (need for admiration, willingness to take big risks)
Personality disorders can make gambling problems harder to treat without specialist support.
Bipolar disorder is associated with problem gambling, particularly during manic episodes:
• Manic episodes can lead to impulsive gambling
• Gambling losses can worsen depressive episodes
• The cycle is particularly damaging
If you have bipolar disorder, monitor your gambling behaviour closely during mood episodes.
Problem gambling is a significant suicide risk factor:
• Problem gamblers are 5-15 times more likely to die by suicide than the general population
• Financial ruin, relationship breakdown, and shame contribute to suicidal thoughts
• Co-occurring depression increases the risk
If you or someone you know is having suicidal thoughts:
• Samaritans: 116 123 (free, 24/7)
• Crisis Text Line: text HELLO to 85258
• NHS 111: for urgent mental health support
• Emergency services: 999 if life is in immediate danger
Suicide is preventable. Help is available.
Many people with mental health problems use gambling as a form of self-medication:
Gambling can provide temporary relief from:
• Depression (excitement, distraction)
• Anxiety (escape from worries)
• Trauma (numbing)
• Loneliness (social connection, even virtual)
But the temporary relief comes at a long-term cost:
• Financial losses
• Relationship problems
• Increased shame and guilt
• Worsened mental health
Gambling as self-medication typically makes mental health conditions worse, not better.
Effective treatment for gambling and co-occurring mental health conditions:
CBT is the most evidence-based treatment for problem gambling:
• Identifies gambling-related thought patterns
• Develops coping strategies
• Addresses underlying beliefs about gambling
CBT is also effective for depression, anxiety, and other co-occurring conditions. Combined CBT can address both issues simultaneously.
MI helps people explore ambivalence about change:
• For gambling: motivation to reduce or stop
• For mental health: motivation to engage with treatment
MI is often the first stage of treatment, helping people get ready for change.
Mindfulness helps people:
• Stay present instead of escaping into gambling
• Recognise urges without acting on them
• Develop healthier coping strategies
Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are both used for problem gambling.
For co-occurring conditions, medication may be helpful:
• Antidepressants for depression
• Anxiolytics for anxiety (short-term only)
• Mood stabilisers for bipolar disorder
Medication for problem gambling itself is limited, but treating co-occurring conditions can reduce gambling behaviour.
Group therapy provides peer support:
• Gamblers Anonymous (12-step model)
• Other group programmes
• Online forums and chat groups
Sharing experiences with others who have similar struggles is helpful for many people.
The most effective approach is integrated treatment that addresses both gambling and mental health:
A single therapist or treatment team addresses both issues. This is more effective than treating them separately.
If treated by different providers (e.g., GP for mental health, gambling counsellor for gambling), coordination is important. Each provider should know what the other is doing.
Recovery from problem gambling and mental health conditions is a long-term process. Treatment isn't a quick fix but a sustained effort.
• NHS: GP can refer to mental health services, including IAPT (Improving Access to Psychological Therapies)
• Mind: mind.org.uk (information and support)
• Samaritans: 116 123 (free, 24/7, for anyone in distress)
• GamCare: gamcare.org.uk (24/7 chat, online forums, one-to-one counselling)
• National Gambling Helpline: 0808 8020 133
• Gamblers Anonymous UK: gamblersanonymous.org.uk
• NHS Gambling Clinics: specialist treatment, referral through GP
Some services address both gambling and mental health:
• GamCare: integrates gambling treatment with mental health support
• NHS Gambling Clinics: address co-occurring conditions
• Private therapists: many specialise in gambling and mental health
If someone you know has gambling and mental health problems:
Both issues benefit from professional treatment. Encourage them to see their GP or contact GamCare.
Listen without judgement. Don't minimise their struggles or lecture them about gambling.
Help them research GAMSTOP, contact their bank about gambling blocks, or set up a GamCare appointment.
Supporting someone with these issues is stressful. GamCare offers support for affected others.
If you're worried about suicide risk, take it seriously:
• Encourage them to call Samaritans (116 123)
• Call emergency services (999) if life is in immediate danger
• Don't leave them alone if suicide is imminent
Seek help if gambling or mental health is affecting your life:
• Spending more than you can afford
• Borrowing to gamble
• Lying about gambling
• Missing work or relationships
• Persistent sadness or anxiety
• Loss of interest in activities
• Sleep problems
• Thoughts of suicide
If both are present, seek help for both. Integrated treatment is most effective.
Free confidential support is available 24/7 for gambling and mental health:
• National Gambling Helpline: 0808 8020 133
• Samaritans: 116 123 (for anyone in distress)
• Crisis Text Line: text HELLO to 85258
• GamCare: gamcare.org.uk (live chat, online forums)
• NHS 111: for urgent mental health support
• Emergency services: 999 (life in immediate danger)
You don't have to face these issues alone. Help is available.