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Gambling odds, as the saying goes, are stacked in favor of the house. But that doesn't stop people from trying to beat the odds.

Approximately 85 percent of American adults report having gambled at some point in their lives, and about 60 percent say they've gambled at least once in the past year. Gambling results in hundreds of billions of dollars in annual wagers — and, for some people, a big problem with compulsive gambling, an addiction.

Most people who wager don't have a problem with compulsive gambling. But some people — an estimated 2 million American adults — become compulsive gamblers at some point in their lifetimes. People who exhibit compulsive gambling lose control of their betting, often with serious consequences. Other people don't meet the diagnostic criteria for compulsive gambling but are considered problem gamblers.

Many people are able to control their compulsive gambling after receiving treatments with medications and psychotherapy, and with the aid of self-help groups.

You may have a gambling addiction if:

• You take time from work and family life to gamble.
• You secretly gamble.
• You feel remorse after gambling and repeatedly vow to quit. You may even quit for a while, but then start again.
• You don't plan to gamble. You just "end up" gambling. And you gamble until your last dollar is gone.
• You gamble with money you need to pay bills or solve financial problems. You lie, steal, borrow or sell things to get gambling money.
• When you lose, you gamble to win back your losses. When you win, you gamble to win more. You dream of the "big win" and what it will buy.
• You gamble both when you feel "down" and when you feel like celebrating.

Imbalances in the brain chemicals serotonin, norepinephrine (adrenaline) and dopamine may be factors in compulsive gambling.

These chemicals all are neurotransmitters. Neurotransmitters are the chemical messengers that enable nerve cells (neurons) to communicate. They're released into the gaps (synapses) between nerve cells to help nerve messages flow from one cell to another. If neurons don't produce enough of these chemicals, nerve messages aren't communicated effectively. Alterations in neurotransmission have been associated with a variety of other mental health problems, including addiction.

Serotonin is a chemical in the brain that plays a key role in regulating mood and behavior. Norepinephrine, a hormone released in response to stress, has been linked to arousal and risk-taking in compulsive gamblers. Brain cells release dopamine as part of the reward system through which you learn to seek pleasurable stimuli, such as food and sex, and dopamine plays a role in developing addiction.

A number of factors increase your risk of a gambling addiction:

• Other behavior disorders. People who gamble compulsively often have substance abuse problems and experience mood and personality disorders.
• Age. You may be more likely to develop an addiction to gambling if you begin to gamble at a young age.
• Gender. Men are more likely than are women to develop a gambling addiction.
• Location. People who live close to a casino are more likely to develop a gambling problem as are those who live farther away.
• Family influence. If your parents had a gambling problem, the chances are greater that you will too.
• Medications used to treat Parkinson's disease. Studies have identified a link between the use of certain Parkinson's disease medications, called dopamine agonists, and the onset of compulsive gambling. These medications also may increase your risk of other compulsive behaviors, such as hypersexuality and compulsive overeating. If you are taking these medications and start behaving in a way that's out of character for you, talk to your doctor.

If your gambling has gotten out of your control, see your doctor for help or for referral to an addiction specialist. Your gambling has gotten out of control if:

• It's affecting your relationships, your finances or your work life
• You're devoting more and more time and energy to pursuing gambling
• You're unable to stop or cut back on your gambling

Seeking help early reduces the risk that your compulsive gambling will lead to severe family problems and financial difficulties.

Because denial is nearly always a characteristic of addictive behavior, it may be difficult for you to recognize a gambling addiction and to seek help on your own. It often takes family members, friends or co-workers to persuade a person with a gambling addiction to seek treatment.

The American Psychiatric Association (APA) classifies compulsive gambling as an impulse-control disorder. To meet the APA's diagnostic criteria for compulsive gambling, a person must show persistent gambling behavior as indicated by at least five of the following criteria:

• Being preoccupied with gambling (for example, reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble)
• Needing to gamble with increasing amounts of money to achieve desired excitement
• Having repeated unsuccessful efforts to cut back or stop gambling
• Being restless or irritable when attempting to cut down or stop gambling
• Gambling as a way to escape problems or to relieve a dysphoric mood (feelings of helplessness, guilt, anxiety, depression)
• After losing money gambling, often returning another day to get even ("chasing" one's losses)
• Lying to family members, therapists or others to conceal extent of involvement with gambling
• Having committed illegal acts, such as forgery, fraud, theft or embezzlement, to finance gambling
• Having jeopardized or lost an important relationship, job, or educational or career opportunity because of gambling
• Relying on others to provide money to relieve a desperate financial situation caused by gambling

Like other addictive behaviors, compulsive gambling can affect many areas of your life, possibly causing:

• Estrangement of family and friends
• Financial problems
• Legal problems, as you may resort to illegal activities to fund your addictive behavior
• Workplace problems
• Development of associated problems, such as excessive alcohol consumption or drug abuse

Treatment for compulsive gambling is similar to therapies for other forms of addiction. Your doctor or mental health professional may use these approaches:

• Psychotherapy. A form of psychotherapy called cognitive behavior therapy focuses on identifying unhealthy, irrational and negative beliefs and having you replace them with healthy, positive ones. Group therapy also may be helpful. In group therapy, you're able to tap into the advice, feedback and support from other people on how to deal with a gambling addiction.
• Medications. Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) may be effective in treating compulsive gambling. SSRIs that your doctor may prescribe include fluvoxamine (Luvox), fluoxetine (Prozac, Sarafem) and citalopram (Celexa). Lithium (Eskalith, Lithobid) may be effective for pathological gamblers with mood disorders, such as bipolar disorder. Naltrexone (ReVia), a narcotic antagonist used to treat alcohol or narcotic addiction, has shown some promise as an effective treatment for compulsive gambling, but more research is needed.

Gamblers Anonymous provides a 12-step program patterned after Alcoholics Anonymous. For people who wonder whether they may have a gambling problem, Gamblers Anonymous publishes a list of 20 questions as a screening tool and provides a list of local chapters.

Your doctor or counselor may be able to refer you to a Gamblers Anonymous group. You may also find state-sponsored help groups in your local telephone directory. Gamblers Anonymous has more than 1,200 U.S. locations and 20 international chapters.