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- 12 July 2023

Healing from Gambling Disorder with TMS: an innovative and effective therapy

Find out what Gambling Disorder is, what are its symptoms and causes, and how it can be cured with Transcranial Magnetic Stimulation (TMS), an effective therapy that can change the brain circuits involved in addiction.


Gambling has always been a popular form of entertainment, especially in Italy, where the tradition of gambling with money is often considered normal and harmless. However, for many people, it can develop into a full-blown addiction with severe consequences for their quality of life.

Understanding its characteristics, causes, and effects on the lives of those who suffer from it is crucial to develop and provide effective treatments.

What is Gambling Disorder?

Gambling Disorder is a mental disorder falling under the diagnostic category of Behavioral Addictions. It is characterized by an uncontrollable urge for gambling, despite the negative consequences it has on a person's life and those around them.

Gambling Disorder can severely impact the quality of life of those suffering from it and affects an increasing number of people worldwide. A study conducted in 2018 by the Italian National Institute of Health revealed, in Italy alone, that approximately 1.5 million people suffer from it.

This form of addiction can lead to serious consequences for a person's life, negatively affecting every aspect of their life: mental and physical health, interpersonal relationships, ability to study or work, and financial stability.

Pathological gambling predominantly affects males, young adults, unmarried people, and those with low incomes. However, it is an addiction that can affect anyone, from adolescents to the elderly. A person suffering from this condition is unable to manage and control the impulse toward gambling, continuing to engage in the behavior despite its obvious harmful consequences. Even though they are aware of the negative effects, the compulsive gambler cannot stop the activity, making it progressively "obligatory."

The Symptoms of Gambling Disorder

In general terms, gambling disorder is characterized by persistent and recurrent maladaptive gambling behavior that negatively impacts an individual's life on a personal, relational, economic, and/or work level.

However, the specific symptoms of pathological gambling can vary from person to person, making it essential to identify them early in order to seek appropriate help and support. Some common symptoms and signs that may indicate the presence of this addiction include:

  • Gambling compulsion: A person with gambling addiction may experience a strong and uncontrollable urge to gamble, which can become more frequent and intense over time.

  • Difficulty quitting: Those suffering from gambling disorder find it extremely challenging to stop gambling, even when experiencing obvious financial losses. They often feel the need to gamble with increasing amounts of money to achieve the same thrill or pleasure or to attempt to recover lost money.

  • Constant preoccupation toward gambling: A person with gambling addiction may worry constantly about gambling, spending a significant amount of time thinking about past winnings or future opportunities.

  • Financial problems: Gambling disorder can lead to severe financial difficulties, accumulating debts, and a tendency to seek new sources of money to fund the gambling activity.

  • Neglect of responsibilities: People with gambling addiction tend to neglect their personal, family, or work responsibilities in favor of gambling.

  • Lies and deceit: Those suffering from pathological gambling may lie to their loved ones or conceal their gambling behavior to avoid being discovered or to hide the extent of the problem.

  • Risky behaviors: Gambling disorder can lead affected people to engage in risky or illegal activities (e.g., theft or drug dealing) to obtain money for gambling.

Some people with Gambling Disorder may experience periods of remission, during which gambling activities decrease or stop entirely. However, these are usually transient periods, after which the person resumes gambling activities again, often more frequently and intensely than before. That's why embarking on a treatment path is of paramount importance. Only in this way can the likelihood of achieving permanent remission and avoiding relapse be increased.

The Causes of Gambling Disorder

The exact causes of gambling disorder are not yet fully understood, but there are various factors that can interact and contribute to the development of this addiction. Some of the primary risk factors include:

  1. Genetic factors: Several studies have shown the existence of a genetic predisposition to gambling addiction.

  2. Environmental factors: Early exposure to gambling, the influence of friends or family members who are pathological gamblers, high accessibility to gambling venues, as well as living in disadvantaged neighborhoods, having low formal education, and having a low socioeconomic status can increase the risk of developing gambling addiction.

  3. Psychological factors: In some people, suffering from Anxiety Disorders, Depression, experiencing a high stress levels, and the presence of other psychological disorders (e.g., Bipolar Disorder, ADHD, or Obsessive-Compulsive Disorder) are factors that can contribute to the development of gambling addiction.

How to Heal from Gambling Disorder?

Recovering from gambling addiction can be challenging, primarily because many individuals with this disorder have difficulty admitting they have a problem. However, the good news is that pathological gambling can be effectively treated with the right approach. Common treatments include:

Despite these interventions, the likelihood of relapse into gambling remains high because they often struggle to effectively address the root causes of the problem. Effective treatment of gambling addiction, therefore, requires a targeted and personalized approach that can deeply and specifically address the underlying causes of the disorder.

Transcranial Magnetic Stimulation (TMS): A Targeted and Effective Treatment

The effective treatment of Gambling Disorder requires an integrated and specialized approach, which starts with a comprehensive and detailed assessment of the patient using specialized tools to obtain a Precision Neuroscientific Diagnosis. Through this type of investigation, it becomes possible to determine how the different dimensions of the gambling experience influence the pathology, thus enabling the focus of the treatment on the specific underlying factors.

Advances in neuroscience have provided valuable insights into the mechanisms underlying gambling addiction. Neuroimaging studies have shown that individuals suffering from a gambling disorder exhibit anomalies in brain regions associated with decision-making, impulse control, and reward processing.

Through the careful and detailed investigation of the prevailing dimensions of the gambling experience lived by the person with gambling addiction ― craving, inability to be aware of consequences, difficulty with inhibition and control, emotional instability ― it then becomes possible to decide the specific brain circuits on which to focus treatment: the reward one, the impulse control one or others.

One promising technique offering this level of selectivity and personalization of treatment is Transcranial Magnetic Stimulation (TMS). TMS uses magnetic fields to stimulate or inhibit specific areas of the brain, modulating neural activity. International scientific literature has shown that TMS represents an innovative treatment for gambling addiction, capable of producing promising results in reducing craving and improving decision-making in individuals suffering from a gambling disorder.

Thanks to its ability to directly act on brain circuits involved in addictions, TMS proves to be a truly effective treatment for gambling disorder. This is what emerges from the findings of a groundbreaking study conducted by the Istituto di Neuroscienze in collaboration with Harvard University and funded by the National Institute of Health (NIH). The research was conducted on a group of 29 patients with Gambling Disorder who received TMS treatment using the innovative Theta Burst Stimulation protocol. Based on the results obtained in this study, it was possible to highlight how this protocol can significantly reduce gambling symptoms, as measured using the PG-YBOCS scale, an assessment tool created by Dr. Stefano Pallanti by adapting the Yale-Brown Obsessive-Compulsive Scale to Gambling Disorder.

Some advantages of TMS treatment include:

  • The treatment is painless and non-invasive;

  • It is a highly safe procedure and causes NO significant side effects;

  • It does not involve the use of medications;

  • It can be administered without hospitalization, allowing patients to continue their daily activities.

Where to Seek Help: The Neuroscience Center for Health

The Neuroscience Center for Health (Centro di Neuroscienze per la Salute), located at the Zucchi Wellness Clinic and directed by Dr. Stefano Pallanti, provides specialized treatments for substance and behavioral addictions.

The center offers an integrated treatment to effectively address Gambling Disorder, at the core of which is Transcranial Magnetic Stimulation (TMS). Dr. Pallanti explained in an interview about gambling addiction: "The initial steps concern implementing a program that first involves the engagement of the patient's family members and also the treatment of any problems related to nutrition, metabolic, and inflammatory issues. Afterward, we proceed with the beginning of a cycle of TMS sessions with the goal of reducing the craving for gambling, increasing control, and improving economic calculation and rationalization skills. The goal is to resist the impulse to gamble and recover one's relationship with oneself and others."

At the core of the treatment plan structured by Dr. Stefano Pallanti is the belief that every change in life is, first and foremost, a change in the brain.

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