Gambling addiction destroys the body from the inside: a psychologist on how to help a patient

Igor Savitsky Psychologist of the rehabilitation department, specialist in working with chemical dependence and codependency at the MINSK Regional Clinical Center "Psychiatry-Narcology"

Since the beginning of this year, gaming disorder has been officially included by the World HEALTH Organization in ICD-11, an updated version of the International Classification of Diseases. Many countries, including Belarus, have previously treated gambling addiction as a problem requiring comprehensive assistance for addicts. Why do some people develop a pathological mental dependence on games, while in others the excessive hobby does not develop into a disease , and how to help if the disorder is present, a psychologist from the rehabilitation department, a specialist in working with chemical dependency and codependency at the Minsk Regional Clinical Center, told BELTA in an interview. Psychiatry-narcology" Igor Savitsky.

- Is the problem of gaming disorder relevant for Belarus? How many patients come for appointments?

- If previously we worked mainly with classic ALCOHOL and drug addiction, then with the development of information technology and the Internet, other forms of addiction appeared, for example, gaming. There are quite a lot of patients: several people come to us every month about this pathology. More often, relatives of addicts come and begin to worry about the obvious consequences of gambling abuse - be it betting in a casino or computer games.

Mostly children and adolescents who are still developing their psyche and personality are affected. The discrepancy between the virtual and real worlds greatly affects the growing organism . In the virtual world, children can demonstrate such personal qualities as resourcefulness, courage, and ingenuity, which is not always possible in the real world. As for adults, their gambling addiction is very often combined with alcohol or drug abuse.

Perhaps I will surprise someone with the following fact, but this is true: an individual, once ill, remains dependent for life. A person who does not use any kind of rehabilitation program to rebuild his lifestyle may switch from one addiction to another. Alcohol addiction often shifts to gaming, drug, and sexual addiction; an eating disorder can develop, and I have encountered such patients.

There are videos circulating on the Internet showing extreme sports enthusiasts gliding down huge mountains. Something goes wrong and the person will be left with only one wet spot. Such life-threatening hobbies are very often used by drug addicts who have given up drugs. They switched to another object, no less life-threatening. There is also a release of adrenaline, the state of consciousness changes, euphoria, pleasure sets in, and then a kind of withdrawal.

- Explain why some people’s passion for video games and gambling does not lead to pathological addiction, while others experience serious disorders? Is it genetic?

- I do not rule out that more recent research has appeared on this matter . However, relying on literature data, as well as personal experience of working with addicts and codependents, I note: 10-15% of addiction is genetically determined. It is not the disease itself that is transmitted, but the predisposition. Otherwise, the habitat, social environment, and economic conditions in which a person lives are of utmost importance. The main role, of course, is given to the family and its influence on the growing person. The personality of a person also matters, whether he knows how to make decisions, how he copes with difficulties in life.

There is a point of view that alcohol addiction is inherited, but I doubt it. My work experience and life observations show that this is not always the case. Children of alcoholics often find a different path in life, right?

Why do some become addicted by starting to use certain chemicals or use behavioral strategies, while others do not? I think it is the predisposition that matters, as well as certain events that occurred during a given period of a person’s individual development: in what family he grew up, in what atmosphere, how he was raised, how he was cared for. The second factor plays the most important role, much more than genetic predisposition.

- It turns out that the mechanisms of development of gaming, alcohol, drug or other addictions are similar?

- The development of alcohol, drug addiction, and gambling addiction is very similar and includes several stages. However, some argue that the process of developing gambling addiction includes one more stage.

At the zero stage of any form of addiction, a person does not need any actions or use of substances that produce the release of hormones, which dramatically change the state of consciousness. He can try, but the body will reject it, turning on its innate defense mechanisms. However, gradually, especially in the presence of a predisposition or psychological preconditions (low self-esteem, unconscious conviction of one’s worthlessness), a certain addiction to the same computer games is formed. If a person is able to regulate their self-awareness in other healthier ways, the addiction will subside over time. If you cannot cope, the next stage arises - the state of addiction.

As for gambling addicts specifically, a state of addiction can arise when there is a strong immersion in the game, when a person plays, for example, 4-6 hours a day. As a result, the child’s academic performance and motivation to study decline, his social circle becomes narrower, sleep and eating are sometimes disrupted, and the theme of the game becomes the main one. Parents may notice how during the game the child’s emotional tone increases; he reacts negatively to any obstacles that may interfere with the game.

This stage, in my opinion, is critical. If at this moment the relatives managed to help the patient or he managed to cope on his own (usually this is still a joint effort), the further development of addiction can be stopped. Despite the fact that addiction at this stage has actually already been built into life, the teenager can still find other healthier strategies for solving his vital problems. He is still able to regulate himself, his condition, and mood with the help of motivation to study or play sports, other hobbies, and communication with peers.

By the way, when a child becomes susceptible to addiction, he begins to go into the virtual world, the connection is broken, isolation appears in his relationship with his parents, they themselves should first of all reconsider their relationship.

At the next stage - with pronounced dependence - internal control is no longer present. The child becomes completely emotionally unstable. If parents include external control, he becomes very nervous, overreacts, becomes hysterical, shows aggression, may leave home, spend time in gambling clubs, and borrow money . This stage is characterized by anxiety, severe excitability, absent-mindedness, and the inability to cope with this outside of gaming activities. If in the game itself a teenager can still concentrate on the process, certain actions, manipulations (although this is illusory control), then outside the game activity he cannot maintain and voluntarily control attention.

Outwardly, this behavior can manifest itself as sloppiness in clothing. The teenager becomes indifferent to himself, his appearance, and even more so to his studies. Missing lessons and decreased performance are a consequence.

The fourth stage of gambling addiction is clinical addiction, which develops when you stay at the computer for 16-18 hours a day or more. A gambling addict exhibits serious deviations in both behavior and reaction (inhibition), lacks emotional and behavioral control, and develops a disorder similar to schizophrenia. For example, a teenager begins to hear voices and certain commands. Irreversible consequences occur. This is already a clinic: hospitalization and qualified medical care are required, a psychiatrist must work with the patient, since a psychologist will not help, this is not his area of ​​expertise.

Some people believe that since a gambling addict does not use chemicals, there is no harmful effect on the body. But no! The body is also destroyed from the inside. A person may have a gastrointestinal disorder. This is apparently a defensive reaction of the individual. Moreover, when playing, in particular betting in a casino, the adrenal glands begin to actively produce hormones. If this happens very often, the whole body suffers. I heard that gambling addicts who do not use rescue and recovery programs often die young, and a number of other consequences are possible.

- But spending a long time playing games is not always considered a pathology, right?

- There are clear criteria for making a diagnosis. If a teenager plays computer games for more than three hours a day or disappears on websites and this begins to interfere with his other interests, motivation disappears, the teenager does not want to communicate with peers, is closed from adults, withdraws into himself, goes into the virtual world, there is a very high probability of developing dependencies. Personally, I would definitely start to worry and would not just leave the situation, since the listed symptoms are quite an alarming signal.

It is, of course, important for parents to control their child’s behavior - but not through an unconditional ban , but with an explanation. It is important to offer an alternative to games, to perform some actions together. However, if we talk about prevention, adults themselves should reconsider their lives. Agree, if one parent disappears on the TV, and the second in the kitchen on the phone, what do you want from the children?

Any addiction reflects not only the problem of a particular child or another family member. If addiction develops in one person, it is a symptom of the entire family structure. This means that something happened or is happening wrong inside.

- What methods are used in the treatment of gambling addiction? How do you evaluate their effectiveness?

- We work according to the classic Minnesota rehabilitation program. Over many decades, it has established itself as the most reliable. Since addiction is a disease that affects a person at all levels - biological, psychological, social and spiritual, an integrated approach is needed. At our center, addicted patients are immersed in a 28-day program. Psychologists and doctors work with them, and they are advised by recovering alcoholics and drug addicts. And then - voluntary integration into anonymous communities of gambling addicts, alcoholics, and drug addicts.

Our rehabilitation program helps addicts change their perception of themselves, what is happening in life, and teaches them to cope differently with their desires, perceptions, thinking, emotionality, and needs.

A person becomes more deeply aware, reconsiders his attitude towards himself, life and, instead of the object of dependence, switches to other forms of behavior. The rehabilitation program is designed over time to bring a person to the moment when he makes his conscious choice - whether to change his lifestyle. This happens without any medications or coding. A person consciously refuses a certain strategy of behavior. The process is quite long, uneven, with ups and downs. In general, working with addicts is one of the most difficult. According to global data, from 2% to 5% of those admitted to rehabilitation departments go into stable remission.

- The International Classification of Diseases also includes other types of addictive behavior, in particular pathological hoarding, compulsive (compulsive) overeating and prolonged grief disorder. Do you encounter such patients in practice?

- Drug and alcohol addiction is often accompanied by eating disorders - overeating and anorexia. And I had to work with it. As for hoarding and prolonged grief, I have seen this in alcoholics and drug addicts as a result of the inability to cope with feelings and experiences. Substance abuse often contributes to long-term depression. However, there are other, in my opinion, no less self-destructive types of addictions - sexual addiction, workaholism, and we also work with this.

A lot of work is built around addicts, but there are codependents - this is an even more severe form of the disease, in my opinion. Codependency reflects the situation of the entire society in which a person lives.

Svetlana VASILEVSKAYA,

BELTA.