when attempting to cut down or stop gambling Has made repeated unsuccessful efforts to control, cut back, or stop gambling Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble) Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed) After losing money gambling, often returns another day to get even ("chasing" one's losses) Lies to conceal the extent of involvement with gambling Has jeopardized or lost a significant relationship, job, education, or career opportunity because of gambling Relies on others to provide money to relieve desperate financial situations caused by gambling Factors that lead to gambling addiction Mayo Clinic specialists state that compulsive gambling may result from biological, genetic, and environmental factors, such as: mental health disorders (the presence of substance use disorders, personality disorders, emotional states) age and sex (usually found in youth or middle-aged people, and more common to men than women) impact of family or friends personality traits drugs with rare side-effects (for example, antipsychotic medications or dopamine agonists). Other studies add the following triggers to the mentioned above: traumatic conditions job-related stress solitude other addictions If not treated, problem gambling may cause severe and lasting effects on an individual's life: relationship related issues problems with money, bankruptcy legal problems, imprisonment health problems suicide, including suicidal thoughts and attempts Suicide rates A gambler who does not receive treatment for pathological gambling when in a desperation phase may contemplate suicide. Problem gambling is often associated with increased suicidal ideation and attempts compared to the general population. Early onset of problem gambling may increase the lifetime risk of suicide. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling. A 2010 Australian hospital study found that 17% of suicidal patients admitted to the Alfred Hospital's emergency department were problem gamblers. Mechanisms Biology According to the Illinois Institute for Addiction Recovery, evidence indicates that pathological gambling is an addiction similar to chemical addiction. It has been observed that some pathological gamblers have lower levels of norepinephrine than normal gamblers. According to a study conducted by Alec Roy, formerly at the National Institute on Alcohol Abuse and Alcoholism, norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their under-dosage. Studies have compared pathological gamblers to