DEAR DOCTOR K:
I used to gamble once a year, on a trip to Vegas. But lately my lifelong battle with anxiety has gotten worse — and so has my gambling. Are they related? What can I do?
Gambling and anxiety do often go hand in hand. People who gamble report feeling less anxious while gambling because the excitement masks anxious feelings. This relief can become addictive, and the impulse to gamble can become overwhelming.
So for many gamblers, reducing anxiety by some other means is necessary in order to control the urge to gamble as a way of dealing with anxiety. There are several techniques that can help.
One of the most powerful ways that people can counteract anxiety is by learning relaxation techniques. Relaxing means more than just sitting on the couch watching TV or a movie. Unless the show is completely absorbing, anxious thoughts can keep breaking through.
Relaxation exercises can teach you to identify worry triggers. Then you can defuse them and break the cycle of anxiety. It’s best to do them every day. The more you do them, the more positive effect they will have. There are many types of relaxation exercises, from the deep breathing exercise I describe below, to mindfulness meditation, to exercises such as yoga and tai chi.
The goal of these exercises is to bring about the relaxation response, which is the opposite of the stress response. By regularly practicing techniques that evoke the relaxation response, you can help your body reduce the cumulative effects of stress.
Relaxation-response techniques slow down your heartbeat and breathing. Your body uses less oxygen and blood flows more easily throughout your body.
One way to relax is through deep breathing or breath focus. Find a comfortable, quiet place to sit or lie down. Begin by taking a slow, deep breath. The air coming in through your nose should move downward into your lower belly. Let your abdomen expand fully. Now breathe out through your mouth (or your nose, if that feels more natural).
Put one hand on your abdomen, just below your belly button. Feel your hand rise about an inch each time you inhale and fall about an inch each time you exhale. Your chest will rise slightly, too. Remember to relax your belly so that each inhalation expands it fully. As you breathe out, imagine that the air leaving your body carries tension and anxiety away with it.
When you first start, 10 minutes of breath focus is a reasonable goal. Gradually add time until your sessions are about 15 to 20 minutes long.
If you need more help in controlling gambling as a response to anxiety, you can find more information in the new book “Change Your Gambling, Change Your Life” by Harvard Medical School’s Howard Shaffer, M.D. You can find out more about it here.
Other treatments for anxiety also can help. Anti-anxiety medicines and cognitive behavioral therapy (a form of “talk therapy”) are effective treatments for anxiety as well.