Everyone likes to get something for nothing. Winning a bet or money at lotto or on a lottery ticket definitely gives a “high”. Most people gamble at least once or twice in a lifetime. For others, gambling becomes their life. They place bets on anything and everything, hoping for a big payout.

Betting and gambling are not new. Gambling been around for centuries and seems to have evolved with civilisation. There is, in fact, a poem called Gambler’s lament which was composed in pre-Vedic times.

Few people, however, realise that compulsive gambling is an addiction (medically called ludomania), on a par with alcoholism or substance abuse. It is a disease that affects about three per cent of the Indian population, mostly males. Since our population is huge, the numbers of ludomaniacs are unbelievably large — and they come from every strata of society.

Ludomania is difficult to diagnose. The affected individual rarely complains as he does not even recognise that there is a problem. There are no external signs or symptoms. It is usually a concerned relative who mentions the compulsion, that too in passing.

An addict is preoccupied with thoughts of gambling all the time. If cards or bets cannot be placed, such people gamble on trivia, for example, the number of red cars that will pass in a five-minute interval. The one symptom of a gambling addict is that financial losses cannot stop the person from gambling.

A compulsive gambler’s brain has less nor-epinephrine and serotonin than normal. This means they feel lethargic and depressed. These chemicals are secreted under conditions of stress or thrill. When he places bets, there is a rush of these chemicals to the brain. A feeling of invincibility and euphoria set in, similar to the high gained from snorting cocaine. As the chemicals get metabolised and depleted, he gets the urge to gamble again. Once the bio-chemical pathways become well established, the speed at which the metabolism occurs keeps increasing. The person begins to gamble for higher stakes at shorter intervals to experience the same high. Gambling disorders start in the late teenage years. The social environment also contributes to its development.

No one wins all the time. As the losses mount up, the addict borrows from loan sharks, steals, lies and pawns jewellery. This may lead to the loss of a job, family or even arrest. Social relationships break down. There may be spouse or child abuse. The depression may drive the person to alcohol and drugs. Eventually, financial stresses and social pressures may drive the person to suicide. About 15 per cent of suicides have a link to gambling.

Treatment of compulsive gambling is difficult. First, the addict and his family may not perceive it as a disease. The addict may also be resistant to advice or therapy. Or he may have tried to quit on his own several times.

Psychiatrists, psychologists and counsellors are needed to tackle the problem. Frequent sessions are needed to reinforce the skills required to stop gambling. Financial help from family members may be needed to recover from debt. The problem is that once they are financially stable, the gambling may start again.

Medication can be used to treat the addiction. Different groups of medication may be needed, depending on the underlying problem. Antidepressants and mood stabilisers may have to be combined with narcotic antagonists. The treatment is similar to that of drug addiction. Gambler’s Anonymous has branches in major cities. This and similar self-help groups help keep the person on the right track.

The desire to stop gambling has to come from within. The person has to realise that the odds are so highly stacked against him that it is unlikely he will win “the next time”. It is best to avoid situations, surroundings and friends who may lead to temptation. Avoid Internet gambling sites even to just “look once.”

Yoga and meditation provide the mental strength required to overcome temptation. Regular aerobic activity for 40 minutes a day will also release endorphins which elevate mood and provide a natural healthy “high” which can act as an antidote to the desire to gamble.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in