Bipolar Disorder and Gambling Addiction

By Dennis Thompson Jr.

Medically reviewed by Pat F. Bass III, MD, MPH

People with bipolar disorder often engage in addictive behaviors. They compulsively shop for things they don't need, engage in frequent and risky sex, or spend long hours at the workplace.

They also are apt to engage in compulsive gambling. People who are bipolar tend toward behaviors that include spending too much money on lottery tickets, spending hours in front of video poker machines, and taking frequent trips to casinos.

Connecting Bipolar Disorder to Gambling

Bipolar disorder causes extreme swings in a person's mood, energy levels, and ability to get things done. It's also known as manic-depressive illness, a name which reflects these swings in mood. Patients can be overexcited and filled with joy and purpose in a manic episode, and then suddenly swing into a depressive episode, becoming sad, joyless, and drained of energy.

Researchers have found that bipolar disorder and gambling addiction often occur together. Half of all gambling addicts in the United States also have a mood disorder, according to one national survey. A Canadian study found that people with bipolar disorder were more than twice as likely to have a gambling addiction as someone in the general population. Another study found that, among those surveyed, a mood disorder preceded gambling addiction in 80 percent of the women and 58 percent of the men

The exact nature of the link between gambling addiction and bipolar disorder has not been fully explained by researchers. Doctors and mental health professionals tend to believe that gambling addiction may be linked to the highs or lows associated with bipolar disorder:

• People with depression use gambling to self-medicate. This theory holds that patients use gambling to help themselves feel better during a depressive phase. The rush associated with the risk of gambling may help them rise out of their depressive funk.
• Gambling reflects the impulsive nature of a manic phase. People in the grips of a manic phase often have impulse control issues. They may engage in kleptomania or go on an eating binge. Some researchers believe gambling might serve as another outlet for impulsive behavior.

Another possible theory is that compulsive gambling may be an early-onset form of obsessive-compulsive disorder, which people with bipolar disorder experience at an increased rate compared with the general population.

Treating Bipolar Disorder and Gambling

If people with bipolar disorder are self-medicating with gambling, that may mean there is a biochemical process they are subconsciously tapping into to ease their mania or depression. They are using a specific behavior to make themselves feel better because that behavior prompts the body to release hormones or neurotransmitters that naturally treat their mood disorder.

Several studies have shown the potential for bipolar disorder medications to also help people deal with a gambling addiction:

• Selective serotonin reuptake inhibitors, or SSRIs, are powerful antidepressants. Studies have found that SSRIs can reduce the need to compulsively gamble in some people.
• Lithium, an often-used mood-stabilizing medication, also has shown promise as a bipolar disorder drug that treats compulsive gambling. Lithium reduces the impulsiveness associated with manic phases and could stop the addictive gambling that takes place when a patient is in the grip of mania.
• Opioid antagonists like naltrexone (Revia) also may help by blocking the release of certain chemicals. Opioid antagonists work on nervous system receptors that respond to opiate drugs. It is thought that gambling and impulsive behavior causes the release of biochemicals that interact with these receptors, causing a feeling of pleasure and reducing the person's sense of impulse or urge. By replacing those biochemicals, opioid antagonists reduce the person's need to gamble to make himself feel better.

Psychotherapy directed at treating bipolar disorder also might help treat a gambling addiction, some research suggests. If the person becomes better able to deal with his mania and depression, he will be less likely to pursue gambling as a means of relieving his symptoms. A combination approach may bring the best results for this difficult combination of disorders.

Last Updated: 07/13/2010

Source: http://www.everydayhealth.com