Uticopa Blog

Christmas is almost upon us. We are bombarded on all sides by lures and enticing goods on display, coupled with increasing demands for more, more, and more from our families.  But, this is not the time to be weak. Some people, particularly men, will resort to things like gambling to feed their craving for money. Others, particularly women, will treat shopping as an addiction rather than a necessity. 

Let's start with gambling.  How to treat it?

Some new research says that the same drugs used to treat substance addictions could prove effective in treating pathological gambling. They tested medications designed to decrease urges and increase inhibitions in two groups of male and female pathological gamblers: those driven by urge (those who gamble when the desire becomes too strong to control) and those who don't have normal inhibitions of impulsive behaviour (they're unable to control the desire to gamble even when the urges are minimal or nonexistent).

The first group - those driven by urge - responded well to medication that blocked the brain opioid system (such as naltrexone) or certain receptors for the neurotransmitter glutamate (such as memantine). Gamblers with a family history of the problem responded especially well to the opioid blocker, the study found.

 The second group - those unable to control any impulse to gamble - responded well to medication that targeted an enzyme called catechol-O-methyl-transferase (COMT), which plays a major role in the function of the prefrontal cortex. By looking at pathological gambling as an addiction and then trying to understand the sense of urge and inhibitions, researchers are more able to target the treatment with medication more effectively.

Impulse Control Disorders
Impulse control disorders feature behaviour that is acted out in an uncontrolled and impulsive manner that often has self-destructive consequences. How often do we see examples of the following incidents in our regional news bulletins?

• Intermittent Explosive Disorder (characterized by uncontrolled fits of extreme anger and violence);
• Kleptomania (characterized by irresistible urges to steal various items from stores and homes);
• Pyromania (characterized by irresistible urges to set fires);
• Trichotillomania (characterized by uncontrollable hair twisting and pulling, often resulting in bald spots on an otherwise normal-haired person) and
• Pathological Gambling (characterized by compulsive, uncontrollable gambling), as described above.

Of course, other disorders involving irresistible urges exist, but are better treated as part of other ‘families' of disorders. Impulse-control problems are also at the heart of substance abuse disorders (addiction to alcohol or drugs).

Do you know anyone exhibiting any of the above? Here are some more details:

Intermittent Explosive Disorder - Symptoms

Several discrete episodes of failure to resist aggressive impulses that result in serious assaultive acts or destruction of property.

The degree of aggressiveness expressed during the episodes is grossly out of proportion to any precipitating psychosocial stressors. The aggressive episodes are not symptoms of another mental health disorder and are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition (e.g. head trauma, Alzheimer's disease).

Kleptomania - Symptoms
Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.
Increasing sense of tension immediately before committing the theft.
Pleasure, gratification or relief at the time of committing the theft.
The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.

Pathological Gambling - Symptoms

Persistent and recurrent maladaptive gambling behaviour as indicated by five (or more) of the following:

• Preoccupied with gambling (e.g. preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble);
• A need to gamble with increasing amounts of money in order to achieve the desired excitement;
• Repeats unsuccessful efforts to control, cut back, or stop gambling;
  Is restless or irritable when attempting to cut down or stop gambling;
• Gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g. feelings of helplessness, guilt, anxiety, depression);
• After losing money gambling, often returns another day to get even ("chasing" one's losses);
• Lies to family members, therapist or others to conceal the extent of involvement with gambling;
• Has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling;
• Has jeopardized or lost a significant relationship, job or educational or career opportunity because of gambling;
• Relies on others to provide money to relieve a desperate financial situation caused by gambling.

One thing's for sure: many of us know someone who fits some of the above symptoms. Our advice?  Whatever your particular ‘addiction', you must resist it!  This is especially true for most of us who do not have the money to indulge ourselves in wild spending sprees outside the usual norms. Be aware of your own compulsions, especially at times such as this.  With Christmas coming, don't give in to try to live up to all those adverts around you.  Just be yourself, and if you can't afford something, tell your family the truth.

A very happy Christmas to all our readers!