Gambling and Mental Health — How Problem Gambling Causes Depression and Anxiety in Australia
Why the connection between gambling and mental health is poorly understood
Most people who seek help for problem gambling do not initially describe it as a mental health issue. They describe it as a financial problem, a relationship problem, or a habits problem. The mental health dimension — the persistent anxiety, the cycles of depression, the shame that compounds over months and years — tends to be identified later, often through clinical assessment rather than self-report.
This pattern reflects a genuine gap in how gambling harm is communicated in Australia. The financial consequences are visible and measurable. The psychological consequences are less often discussed, even though research consistently shows they are among the most severe and long-lasting effects of problem gambling.
Understanding the relationship between gambling and mental health is not supplementary to understanding problem gambling. For a significant proportion of those affected, it is the central issue.
The scale of problem gambling in Australia in 2025
Australia's problem gambling figures have increased consistently over the past three years. Roy Morgan research tracking the Problem Gambling Severity Index (PGSI) among Australians 18 and over shows a clear upward trajectory:
1.9% of Australian adults classified as problem gamblers in 2022–23
2.4% in 2023–24
2.9% in 2024–25
At 2.9%, that figure represents more than 620,000 Australians currently experiencing severe gambling-related harm — a number that has grown in each of the last two years, against a background of declining rates of low-risk gambling. The pattern suggests that the moderate gambling middle ground is shrinking while the severe end is growing.
What is less frequently reported alongside these statistics is the mental health burden those numbers represent. Among problem gamblers identified in PGSI surveys:
4.9% report that gambling has caused them health problems including stress or anxiety
Rates of depression are significantly elevated compared to the general population
Rates of anxiety disorders are similarly elevated
The relationship between problem gambling and mental health is not incidental. It is structural.
Depression in problem gamblers — what the research shows
The evidence for a relationship between problem gambling and depression in Australia is now well-established across multiple study designs.
Research published in the Australian & New Zealand Journal of Psychiatry (Dowling et al., 2015), a systematic review and meta-analysis of psychiatric comorbidity in treatment-seeking problem gamblers, found markedly elevated rates of mood disorders — including major depression — among people seeking treatment for gambling disorder. The review, covering multiple studies of Australian and international populations, established that psychiatric comorbidity in problem gambling is the norm rather than the exception.
The causal relationship runs in both directions, which complicates both research and treatment:
Depression as a precursor: individuals with depressive symptoms gamble more frequently as a form of self-medication, seeking stimulation or escape from low mood; this pattern is well-documented and consistent across studies
Depression as a consequence: the financial losses, social deterioration, and shame associated with problem gambling reliably produce depressive episodes in people who did not have pre-existing depression
Depression as a maintaining factor: once established, depressive symptoms reduce the cognitive resources available for decision-making, making it harder to interrupt gambling behaviour even when the person recognises the harm
This bidirectional relationship means that treating problem gambling without addressing depression — or addressing depression without addressing gambling — produces limited outcomes. The conditions reinforce each other and need to be understood together.
Anxiety disorders and problem gambling
The connection between gambling and anxiety is less frequently discussed than the gambling-depression relationship, but the evidence base is similarly consistent.
Problem gamblers report elevated rates of:
generalised anxiety disorder — persistent, difficult-to-control worry that extends well beyond gambling contexts
social anxiety — particularly around financial disclosure, which becomes increasingly difficult as gambling losses accumulate
health anxiety — often emerging after sustained periods of high stress
panic symptoms — particularly in contexts where financial consequences feel acute and unavoidable
A prospective longitudinal study using data from the Australian Temperament Project (Merkouris et al., 2021, published in the Journal of Clinical Medicine, DOI: 10.3390/jcm10071406) examined the relationship between mental health symptoms in adolescence and early adulthood and gambling problems in adulthood. Spanning seven waves of data collection and 1,365 participants, the study found that prior anxiety symptoms predicted gambling problems in adulthood — not simply alongside other risk factors, but as an independent predictor.
This finding has implications for prevention. Anxiety is not simply something that problem gambling causes; it is something that makes people vulnerable to developing problem gambling in the first place. Early identification and treatment of anxiety disorders may have a protective effect against subsequent gambling harm.
Suicide risk and gambling disorder in Australia
The most serious mental health consequence of problem gambling is elevated suicide risk, and this dimension requires direct acknowledgement rather than treatment as a footnote.
Research conducted by Auckland University of Technology and Deakin University in Melbourne, examining gambling disorder in Australia and New Zealand, found that gambling disorder functions as a catalyst for profound mental health crises, including suicidal ideation and behaviour. The pathways are multiple:
acute financial crisis producing a sense of inescapability
shame and anticipated social consequences reducing the perceived costs of self-harm
social isolation removing protective relationships and increasing access to means
comorbid depression reducing cognitive resources for crisis management
Australian clinical and research data consistently place problem gamblers at elevated risk of suicidal ideation and attempted suicide compared to the general population. This risk is not adequately captured by prevalence statistics alone and requires specific clinical attention in any assessment of someone presenting with gambling disorder.
The 24/7 Gambling Help Hotline (1800 858 858) operates as both a gambling support and a crisis resource, and calls involving suicidal ideation are handled within established protocols for mental health emergencies.
Why only 20% of problem gamblers seek help — and what that means
One of the most significant findings in the research literature on gambling treatment in Australia is the treatment gap: approximately only 20% of people with gambling problems seek professional help. The barriers are well-documented:
Shame and self-stigma — gambling is culturally framed as a choice rather than a disorder, making it difficult to seek help without implicating personal character
Self-reliance norms — particularly prominent among male gamblers, who represent a disproportionate share of problem gambling presentations
Minimisation — the gradual onset of gambling harm allows progressive normalisation of worsening symptoms
Practical barriers — geographic access, cost concerns, and lack of awareness of available services
The mental health dimension makes this treatment gap particularly significant. For the majority of people not seeking help, the depression and anxiety associated with their gambling are also going unaddressed. The cumulative mental health burden of untreated gambling disorder accumulates over months and years in ways that complicate eventual treatment and recovery.
From a public health perspective, reducing the treatment gap requires not only improving access to services but changing the framing through which problem gambling is understood — from a financial failure requiring personal correction to a health condition requiring professional support.
Effective treatments for gambling-related mental health problems
The evidence base for treating gambling disorder and its mental health comorbidities has developed significantly in the past decade. The most robustly supported interventions include:
Cognitive Behavioural Therapy (CBT) remains the most extensively studied treatment for gambling disorder. It directly addresses the cognitive distortions — the erroneous beliefs about luck, probability, and control — that maintain gambling behaviour, and it provides frameworks for managing the depressive and anxiety symptoms that accompany problem gambling. CBT for gambling typically spans twelve to twenty sessions and can be delivered individually or in group formats.
Motivational Interviewing (MI) is effective in the early stages of treatment, particularly for individuals who are ambivalent about change. It works with rather than against resistance and has been shown to improve engagement and retention in subsequent treatment.
Integrated treatment approaches that address gambling and comorbid mental health conditions simultaneously are emerging as the standard of care. Treating gambling and depression or anxiety in parallel, rather than sequentially, produces better outcomes than treating one and expecting the other to resolve.
Pharmacological support — while no medications are specifically approved for gambling disorder in Australia, some medications used for depression and anxiety (particularly SSRIs) may support recovery, particularly in individuals with established comorbid mood or anxiety disorders. Pharmacotherapy decisions should involve a GP or psychiatrist.
All of these treatments are available through free and subsidised services in Australia, including the network of gambling help counselling services funded through state and territory governments.
Recognising mental health signs in someone affected by problem gambling
The mental health consequences of problem gambling can be subtle in early stages and are often masked by the more visible financial and behavioural signs. Recognising psychological change in someone affected — whether the gambler themselves or a family member — requires attention to patterns rather than single events.
Signs that may indicate significant mental health impact include:
withdrawal from social contact that was previously valued
persistent low mood that does not lift with positive events
sleep disruption, particularly early waking with rumination
increased irritability or emotional volatility without clear cause
expressions of hopelessness about the future, particularly financial future
loss of interest in activities unrelated to gambling
increased alcohol or substance use alongside gambling
These signs do not confirm a diagnosis. They indicate that professional assessment is warranted and that the support needed extends beyond financial counselling.
Getting help in Australia
Support for gambling-related mental health problems is available through multiple national and state pathways:
Gambling Help Online: gamblinghelponline.org.au — free chat, email counselling, and telephone support available 24 hours
Gambling Help Hotline: 1800 858 858 — free, confidential, available 24/7
State-funded gambling counselling: available in every state and territory through community health services; free and confidential
GP referral: a GP can initiate a Mental Health Treatment Plan providing access to up to twenty subsidised sessions with a registered psychologist under Medicare
Lifeline: 13 11 14 — if gambling-related distress has reached a crisis point
Early contact with any of these services is appropriate — help does not require waiting until the situation has reached its worst point. The research evidence is clear that earlier intervention produces better outcomes across both gambling behaviour and associated mental health.
Conclusion
The relationship between problem gambling and mental health in Australia is not peripheral to the gambling harm story — it is central to it. Depression, anxiety, and elevated suicide risk are consistent findings across the research literature, and they affect both people who gamble problematically and those close to them.
The growing prevalence of problem gambling in Australia — rising from 1.9% to 2.9% of adults in three years — represents a corresponding growth in mental health burden that existing services are under pressure to address. Understanding that gambling disorder is also a mental health condition, rather than simply a financial or behavioural problem, is the first step toward reducing both the treatment gap and the harm.
Frequently Asked Questions
Can gambling cause depression even if I don't have a history of mental health problems? Yes. Research consistently shows that problem gambling produces depressive symptoms in people with no prior history of depression. The financial, relational, and social consequences of gambling disorder are sufficient to cause significant depressive episodes independently of any pre-existing vulnerability.
Is gambling addiction considered a mental health disorder? Yes. Gambling disorder is classified in both the DSM-5 (the American Psychiatric Association's diagnostic manual) and the ICD-11 (the World Health Organisation's classification) as a recognised mental health condition — specifically as a behavioural addiction. This classification reflects decades of neuroscientific and clinical research.
What is the most effective treatment for gambling and depression together? Integrated treatment that addresses both conditions simultaneously is more effective than treating them sequentially. Cognitive Behavioural Therapy adapted for gambling disorder addresses both the gambling behaviour and the accompanying depression and anxiety. A GP or mental health professional can help develop a treatment plan that covers both dimensions.
Does gambling anxiety get better on its own when gambling stops? For some people, anxiety symptoms reduce significantly when gambling behaviour stops, particularly if the anxiety was primarily related to financial stress and concealment. For others, anxiety persists and requires its own direct treatment. Early professional assessment helps clarify which pattern applies and what intervention is needed.
How do I help a family member who is gambling and showing signs of depression? Professional support is available for family members of problem gamblers through gambling help services. You do not need to wait until the person who gambles is ready to seek help — you can access support for yourself first. Gambling Help Online and state gambling counselling services work with affected family members.