Gambling & betting

What is gambling addiction?

Gambling addiction, known medically as gambling disorder, is when betting or gambling becomes hard to control and carries on even as it causes serious harm. The World Health Organization (WHO) includes it in ICD-11, the international classification of diseases, as a disorder due to addictive behaviour. It has three main features:

• Impaired control: difficulty controlling how often, how much or how long a person gambles, or stopping once started
• Increasing priority: gambling comes before work, studies, family, sleep and other interests
• Continuing despite harm: gambling goes on, or increases, even as losses, debts and conflict pile up

For a diagnosis, the pattern must cause significant problems in personal, family, social, educational or work life. It is normally present for at least 12 months, although it can be diagnosed sooner when the problems are severe.

WHO estimates that about 1.2 in every 100 adults worldwide has gambling disorder, and many more experience some harm from gambling. In India, a study of nearly 5,000 school students aged 15 to 19 in Kerala found that about 28 in 100 had ever gambled and about 7 in 100 had a gambling problem. A similar study of college students in South India also found that about 7 in 100 had a gambling problem.

It is not a sign of greed or bad character. Gambling acts on the brain’s reward system, and many products are designed to keep people playing.

Gambling and betting today

Gambling means putting money, or something valuable, on an uncertain result in the hope of winning more. In India it takes many forms, old and new:

• Sports betting, especially on cricket during IPL and other tournaments, through local bookies or online betting apps
• Fantasy sports played with paid entry fees and cash prizes
• Card games played for money, such as teen patti, rummy and poker, at home, at festival gatherings or on apps
• Lotteries, satta and matka
• Casino-style apps and websites, with spinning wheels, slots and live card tables
• Speculative trading that works like gambling for some people, such as very frequent, high-risk, short-term bets on share prices or cryptocurrency, driven by the thrill rather than a financial plan

Whether an activity is called a game of skill, a game of chance or an investment, the health question is the same. Is the person losing control, chasing losses and causing harm?

Online gambling adds extra risks. It is on the phone all day, money moves in seconds through UPI or wallets, bets can be placed every few minutes during a match, and bonuses and advertising pull people back. It is also easy to hide. Studies of Indian students show that young men are most often affected. In one study of college students, about 1 in 5 had played fantasy sports, and those who had lost money tended to play more often.

Signs to look out for

You or someone close to you may have a problem if you notice several of these:

• Betting more money, or more often, to get the same excitement
• Chasing losses: going back to win back money that has been lost
• Repeated failed attempts to cut down or stop, and broken promises
• Restlessness or irritability when trying to cut down
• Thinking about gambling most of the time, such as studying odds, following matches only for bets, or planning the next bet
• Gambling to escape stress, boredom, loneliness or low mood
• Lying about where money or time has gone
• Borrowing from family, friends or colleagues, often with vague reasons
• Taking loans, maxing out credit cards or using instant-loan apps
• Selling or pawning gold, a phone or other belongings, or money going missing at home
• Unpaid bills, rent or fees, despite a steady income
• Falling performance at work or college, or missed days

Doctors look at the overall pattern, how long it has been going on and how much it affects daily life, rather than any single sign.

When does betting become a problem?

No fixed amount of money decides it. Some useful questions:

• Do you bet more than you planned, or more than you can afford to lose?
• Have you ever gone back to try to win back losses?
• Have you borrowed money or sold something to gamble or to pay gambling debts?
• Do you hide gambling from family?
• Has gambling caused money problems, arguments, stress or poor sleep?

If the answer to any of these is yes, it is worth talking to a professional.

Why does it happen?

There is rarely a single cause. Several factors usually combine:

• The way gambling works. Unpredictable wins, near misses and fast repeat bets are powerful rewards. An early big win can make gambling feel like a quick route to money.
• Beliefs about skill. Deep knowledge of cricket, cards or markets can create a false sense that one can predict or control results.
• Money pressure. Debts, low income or the wish to get rich quickly can make a big win feel like the only way out.
• Mental health. Depression, anxiety, stress and ADHD are common in people with gambling problems.
• Alcohol and other substances. Indian studies found that students with gambling problems were more likely to use alcohol, tobacco and cannabis.
• Age and sex. Young men are at higher risk, though women and older adults are affected too.
• Environment. Friends who bet, gambling advertising during sport, easy online access and life changes such as separation, retirement or bereavement can all add to the risk.

How it affects the person and family

Gambling disorder affects much more than money:

• Finances: debts, lost savings, sold jewellery or property, and damaged credit
• Mental health: anxiety, shame, guilt, poor sleep and depression
• Work and studies: poor concentration, missed days, job loss or failed exams
• Relationships: broken trust, constant arguments, separation, and less time and care for children
• Safety: pressure from lenders, and sometimes taking money that isn’t theirs in desperation

Families carry much of the burden. WHO estimates that for every person who gambles at high-risk levels, about six others, usually family members, are affected. The encouraging news is that with treatment and a clear plan, trust and finances can be rebuilt over time.

Money, debt and safety

Gambling does not cause dangerous physical withdrawal, but its money problems can quickly become a crisis.

The debt cycle. It often starts with a loss the person wants to win back. They borrow to bet again, lose, and borrow more to cover the first debt. Many people hide this for months, and debts often turn out larger than first admitted.

Instant-loan apps. Quick loans through apps can pile up fast, often with high charges. Some people take several at once to repay each other, and some borrowers face harassing calls or messages. If anyone is threatened or blackmailed, keep screenshots and records, and report it to the police or the national cybercrime reporting portal.

Suicidal thoughts. Gambling problems carry a higher risk of suicidal thoughts, especially when debts feel overwhelming or a secret comes out. These thoughts are a sign of severe distress, and they can be treated. Debts, however large, can be worked through with support. Take any talk of hopelessness seriously, stay with the person, and seek help. Call Tele-MANAS on 14416, any time, or 112 in an emergency.

A money-safety plan. Families can help keep money safe while treatment starts. This works well when it is agreed with the person, explained as temporary protection rather than punishment, and reviewed as recovery progresses.

• A trusted person handles finances for a while. A spouse, parent or sibling manages income, bills and savings, with a small, agreed amount of cash for daily needs.
• Block access. Delete betting and casino apps, use blocking tools on phones and computers, and remove saved cards and UPI from the person’s phone.
• Talk to the bank. Ask about lowering daily transaction limits, switching off online or international card transactions, and not issuing new credit cards.
• Stop new borrowing. Close relatives and friends can be told, discreetly, not to lend money.
• List every debt honestly. Write down who is owed, how much and when it is due. This step is hard, but essential.
• Don’t pay off debts without a plan. Clearing debts in one go can feel like a fresh start, but it often removes the pressure to change and frees up credit for more gambling. Agree a repayment plan first, pay lenders directly rather than handing over cash, and link it to treatment. A financial counsellor can help prioritise and negotiate.
• Protect family assets. Keep jewellery, cheque books, property papers and passwords secure, and avoid signing as guarantor for any new loan.

When to see a psychiatrist

Consider speaking to an addiction psychiatrist if:

• You have tried to cut down or stop gambling and haven’t managed to
• You are chasing losses, borrowing or hiding debts
• Gambling is affecting your work, studies, sleep or relationships
• You gamble to cope with stress, sadness or anxiety
• Family members are worried or money is going missing
• You feel hopeless, trapped or overwhelmed by debt

You don’t need to wait until the losses are huge. Early help is simpler and more effective.

How gambling addiction is diagnosed

A first consultation is a conversation, not a judgement. The psychiatrist will ask about the types of gambling, how often and how much, losses and debts, attempts to stop, mood, sleep, alcohol or other substance use, stress, family history and what you would like to change. With your permission, a family member can join part of the discussion.

An important part of the assessment is checking for depression, anxiety, ADHD, bipolar disorder and alcohol use, and asking gently about thoughts of self-harm, so that safety is part of the plan. Questionnaires may help measure severity. The diagnosis follows international criteria (ICD-11), and the plan is built around your goals.

Treatment

Treatment is tailored to the person, and it usually combines the following.

1. Building motivation and agreeing goals

Many people feel ashamed, or believe they can fix things with one more win. Motivational conversations help them weigh what gambling is costing them against what they care about, such as family, career and peace of mind, so that change becomes their own decision. For most people, the goal is to stop all forms of gambling.

2. Cognitive behavioural therapy (CBT)

CBT is the main psychological treatment for gambling disorder. Research reviews show it reduces gambling in the period after treatment, and NICE recommends it, either in a group or individually. CBT commonly includes:

• Recognising triggers, such as matches, payday, boredom, alcohol, stress or an argument
• Challenging beliefs like “I’m due a win” or “I know this game well enough to beat the odds”
• Handling urges without acting on them, and planning for high-risk times like tournaments
• Rebuilding a daily routine, hobbies and social life that don’t involve betting
• Solving money and life problems in practical steps

3. Family and financial counselling

Gambling affects the whole family, so families are involved with the person’s consent. Sessions help to reduce blame and conflict, rebuild trust, agree and review the money-safety plan, and give family members support of their own. Financial counselling helps list debts, set priorities, plan repayments and handle pressure from lenders.

4. Treating depression, anxiety and alcohol use together

Depression, anxiety, ADHD and alcohol or other substance use are common alongside gambling, and they can fuel it. Treating them at the same time lowers the risk of relapse. This may include counselling and, where needed, medicines such as antidepressants. In some cases, a specialist may consider a medicine that reduces gambling urges. Medicines should only be started, changed or stopped by a doctor.

Outpatient, online or inpatient care?

• Outpatient care suits almost everyone, with regular sessions while living at home and working or studying.
• Online consultations work well for therapy, family guidance, follow-up and people outside Delhi NCR.
• Inpatient care is needed only occasionally, for serious safety concerns, severe depression, or alcohol or drug dependence alongside gambling.

Dr. Tarwani sees patients at Sukoon Health in Gurugram and South Delhi, where inpatient rehabilitation is also available, and online.

Recovery and relapse

Recovery is gradual. Big tournaments, festival card parties, a bonus or salary day, a win by a friend, alcohol, or pressure from debts can all bring back urges.

A slip does not mean treatment has failed. The right response is to be open about it quickly, review what triggered it, tighten the money-safety plan for a while, and carry on with treatment. With time and support, many people stop gambling, clear their debts and rebuild their relationships.

For families

Finding out about hidden gambling and debts can bring shock, anger and fear. These steps tend to help:

• Talk at a calm moment. Describe specific concerns (“Money is missing from the account and I’m worried”) rather than using labels like liar or cheat.
• Keep safety first. Take any talk of hopelessness seriously, and stay close during a crisis, such as when large debts first come to light.
• Don’t rely on promises alone. Sincere promises to stop are common, but a plan and treatment work better.
• Avoid rescuing without a plan. Repeatedly covering losses or making excuses to relatives can delay change.
• Protect yourself. Keep household money and your own savings separate, and don’t take loans in your name for the person.
• Share the load. Involve one or two trusted relatives rather than keeping it secret, avoid public shaming, and look after your own health and sleep.

If a young person is betting, talk calmly, check for use of parents’ cards or UPI, and seek help early. You are welcome to consult Dr. Tarwani first, on your own, to plan the next steps.

Common myths

• “It’s just greed, he can stop if he wants to.” Gambling disorder is a recognised health condition that affects control. Willpower alone often isn’t enough, which is why treatment helps.
• “One big win will solve everything.” Chasing losses usually deepens debt. Even after a win, people with gambling disorder tend to bet it again.
• “Fantasy sports and card games on apps aren’t real gambling.” When money is staked on an uncertain result and control is lost, the harm is the same.
• “If we clear the debts, the problem will go away.” Paying debts without treatment and a plan often leads to more gambling.
• “It’s not an addiction because there’s no drug.” Gambling disorder is classified alongside other addictive disorders and responds to similar treatment.