Whether it’s buying a lottery ticket, betting on sports events or the pokies (Australian slots), or playing video games, most adults have gambled at some point in their lives. But for some people, gambling becomes a problem. Pathological gambling is a mental health disorder characterized by persistent and recurrent maladaptive patterns of behavior that cause substantial distress or impairment. Despite the high comorbidity of PG with substance use disorders, it has been a neglected area of research, and only recently did DSM-5 recognize it as an addictive disorder.

Unlike most addictions, which often have identifiable roots and causes, such as childhood trauma or genetic predisposition, the root of gambling is usually unclear. However, researchers know that the brain is especially sensitive to rewards, and that a particular neurotransmitter—dopamine—is involved in the rewarding and pleasure aspects of gambling.

It also seems that a gambling disorder is linked to the way the brain’s reward circuits are wired, and that it can be triggered by environmental factors like stress or social isolation. It may be particularly common among people who start gambling in their early 20s, and studies suggest that it is more likely to affect males than females.

Fortunately, treatment and recovery are possible. The first step is admitting that you have a problem, and this takes courage—particularly if you’ve lost a lot of money or suffered strained relationships because of gambling. Then, you can start to find healthier ways to relieve unpleasant emotions or boredom, such as exercising, spending time with friends who don’t gamble, taking up new hobbies, or practicing relaxation techniques.