Gambling and mental health problems tend to grow together. Low mood can push someone towards a bet that promises relief, and the losses, debt, and secrecy that follow drag it lower.
Depression, anxiety, suicidal thoughts, heavy drinking, and ADHD all connect to gambling in different ways. Each has its own route to help, and many free South African services treat both problems at once, whether the worry is your own gambling or someone else's.
Free help, 24 hours a day. Call the National Responsible Gambling Programme (NRGP) on 0800 006 008 or WhatsApp 076 675 0710. For thoughts of suicide, call the SADAG Suicide Crisis Helpline on 0800 567 567.
Gambling and mental health problems feed each other
Some people bet to take their mind off a hard day, and a match or a spin gives a few minutes of relief. Losses bring money worries, and the secrecy around them adds guilt. Both make the urge to bet stronger, so one problem keeps the other going.
The pattern holds in South Africa. Researchers surveyed 3,000 adults in the country's cities. People at risk of a gambling problem were more likely to struggle with depression, anxiety, alcohol or drugs.
Further afield, a 2025 review of population surveys from several countries shows how frequently specific conditions appear with gambling disorder.
Condition
Share of people with gambling disorder
Anxiety disorders
29.9%
Alcohol use disorder
27.8%
Drug use
22.5%
Major depression
20.3%
Bipolar disorder or manic episodes
18.6%
These conditions overlap, so one person may live with two or three at once. Because of that overlap, the psychological effects of gambling reach well past money, from broken sleep to constant worry.
Mood usually changes first, before any money trouble shows. Irritability and less time with family can be early warning signs of a gambling problem.
Depression and anxiety often follow losses
Heavy losses hit hard. After a run of bad bets, many people feel flat, ashamed, and unable to sleep, and they place another bet to win the money back. When that fails, their mood sinks lower and the next bet starts to look like the only fix.
Local treatment data show gambling and depression often go hand in hand. Among 200 South Africans in treatment for gambling, 28% had major depression at the time, and 25.5% had an anxiety disorder. Close to half had lived through depression at some point, and women showed higher rates than men.
Research can't always say whether gambling causes depression or the other way round, and gambling can cause anxiety as well, particularly once debts pile up or bets stay hidden from a partner. Because these shifts creep in slowly, keep an eye out for the following in yourself or someone close to you.
Trouble with sleep, or nights spent awake over bets and scores
Loss of interest in things you used to enjoy
Snapping at people over small things
Constant worry about money, debit orders or the next payday
If any of these last two weeks or longer, book a chat with a GP or counsellor.
Suicide risk rises with gambling harm in South Africa
Gambling and suicide risk are linked, usually together with debt, isolation and other mental health conditions. If suicidal thoughts feel close to home, call South Africa's suicide helpline, the SADAG Suicide Crisis Helpline, on 0800 567 567, day or night.
The NRGP recorded 1,298 cases of suicidal thoughts linked to gambling in 2026, a 38.5% rise on the year before. About six in ten involved young adults aged 18 to 35.
Depression and suicidal thoughts often go together, so treatment for low mood is part of suicide prevention. Suicidal thoughts can pass, and people do get through them with support. Debt also looks less hopeless once a debt counsellor or a payment plan breaks it into manageable steps.
When someone you know may be at risk
Gambling debt can make a person feel trapped, and any talk of suicide needs a calm, direct response. Four steps help in the first hour, before professional support takes over.
Ask them plainly whether they have thoughts of suicide. The question won't put the idea in their head, and it shows you're ready to listen.
Stay with them, or make sure someone else does, and call the SADAG Suicide Crisis Helpline on 0800 567 567 together.
Phone 112 from a cellphone or 10111 for the police if they're in immediate danger.
Help them reach ongoing support once the crisis passes, such as the NRGP for the gambling itself.
Families need support of their own after a scare like this. Practical ways to help someone you love with a gambling problem can ease the pressure at home and keep the conversation open.
Alcohol, drugs and other addictions travel together
Alcohol lowers inhibition and blurs judgement at the exact moment a game swings and a bettor needs a clear head. Volunteers who drank alcohol bet more after a loss than after a win, while sober volunteers didn't.
In South Africa, the two can share a venue. Limited payout machines stand in pubs, taverns and other licensed sites, and the National Gambling Board counted close to 16,000 active machines at the end of March 2024. One drink beside a slot machine can turn into several bets.
Limpopo data puts a number on the link between gambling and alcohol addiction. Hazardous or harmful alcohol use came with nearly seven times the odds of high-risk gambling for 900 gamblers surveyed there. Awareness of the free gambling helpline was low, particularly outside the cities.
Cross addiction and process addiction
Gambling is a process addiction, which means the pull comes from an activity instead of a drug or drink. Shopping and gaming can hook people in the same way. Cross addiction is when one habit takes over from another, for example, when someone gives up betting and drinks more instead.
Swaps happen less often than many people fear. People are more likely to cut back on several habits together, though those who do swap face more severe problems. Tell a counsellor about every habit, and the plan can cover all of them.
For alcohol or drugs, South Africa's substance abuse helpline, a Department of Social Development service, also works as the national drug helpline and answers alcohol and drug calls 24 hours a day on 0800 12 13 14, or SMS 32312. SANCA operates treatment centres across the country and takes calls on 011 892 3829.
ADHD, bipolar disorder and some medicines can raise the risk
Certain conditions shape how the brain handles reward and impulse, which can make gambling harder to control. Three stand out in the research, each with its own warning signs.
ADHD and gambling addiction
ADHD brings impulsivity and a pull towards quick rewards, and in-play markets and fast games play straight into that. ADHD symptoms show a small but steady link with more serious gambling problems.
Across 36 studies of people in gambling treatment, about 9% had ADHD. SADAG also offers a dedicated ADHD helpline on 0800 55 44 33 from 8 am to 8 pm.
Bipolar disorder
Manic or hypomanic episodes can bring bursts of confidence and big purchases, and large bets can follow close behind.
People with bipolar disorder are about four times more likely to have a moderate or severe gambling problem than the general population. The risk climbs higher still when moods swing quickly.
Medicines that affect dopamine
Dopamine agonists, a group of medicines prescribed for Parkinson's disease and restless legs syndrome, can trigger compulsive gambling in some people. Among Parkinson's patients on these medicines, about one in six develop impulse control problems such as compulsive gambling, compared with roughly one in fifteen of the rest.
If gambling urges started or grew after a new prescription, raise them with the prescribing doctor straight away. A lower dose or a different medicine can settle them, and a supervised switch keeps it safe.
Withdrawal-like symptoms usually ease with time
The first weeks without a bet can feel rough, and gambling withdrawal symptoms are as emotional as they are physical. Around four in ten gamblers who try to cut down report withdrawal-like feelings, from anger to guilt and disappointment.
Those feelings can be intense. Problem gamblers rate their withdrawal about as severe as people dependent on alcohol do, and the worst moments cluster around familiar betting times.
Restlessness around match times, paydays or the hour you used to play
Irritability, a short temper and little patience with family
Poor sleep, or dreams about bets and wins
Strong urges, set off by adverts or a big fixture
Much of that anger and guilt traces back to what the bets used to cover, like stress, loneliness or a flat mood. Once you name the feeling, you can answer it another way, with a call to a friend or a walk. Put those swaps into a coping plan before the hardest weeks begin.
Deep hopelessness or thoughts of self-harm need urgent support. Ring the SADAG Suicide Crisis Helpline on 0800 567 567, any time.
Free help in South Africa covers both problems
Some services focus on gambling, while others cover mood, crisis or substance use, and each can point you to the next step. The 0800 numbers are toll-free.
Service
Helps with
Contact
Hours
National Responsible Gambling Programme
Gambling problems, for gamblers and families
0800 006 008, or SMS or WhatsApp "help" to 076 675 0710
24/7
SADAG Suicide Crisis Helpline
Suicidal thoughts and crisis support
0800 567 567
24/7
SADAG Cipla Mental Health Helpline
Depression, anxiety and other mental health concerns
0800 456 789, or SMS 31393
24/7
Lifeline South Africa
Trauma, emotional distress and relationship problems
0861 322 322
24/7
Substance abuse helpline
Alcohol and drug problems
0800 12 13 14, or SMS 32312
24/7
SANCA
Assessment and treatment for alcohol and drug dependence
011 892 3829, or WhatsApp 076 535 1701
Office hours
Last verified: October 2026
Free counselling in South Africa through the NRGP starts with a phone assessment, so mention mood, sleep, alcohol, or medication on that first call.
With the full picture, the counsellor can arrange support for both problems together, which clinicians call dual diagnosis care. Longer-term recovery may need professional treatment that treats gambling at the same time as depression, anxiety or substance use.
Support for low mood and anxiety. SADAG's Cipla Mental Health Helpline answers 24 hours a day on 0800 456 789, and Lifeline South Africa takes calls on 0861 322 322. For gambling support, call the NRGP on 0800 006 008.
Your GP can usually tell after a few screening questions about mood, sleep, and spending. Mention the gambling openly, because it changes what the doctor looks for and where they refer you. If you'd prefer to talk by phone first, SADAG's depression and anxiety helpline answers on 0800 70 80 90 from 8 am to 8 pm.
Gambling withdrawal doesn't put the body at physical risk the way alcohol withdrawal can, so you can stop without a medical detox. The danger lies in urges and low mood, which can push someone back to a bet or towards hopelessness. If dark thoughts appear, call the SADAG Suicide Crisis Helpline on 0800 567 567 straight away.
Gambling can trigger panic attacks, most often after a heavy loss or when hidden debts come close to discovery. Panic disorder affects about 14% of people in gambling treatment. Chest tightness, a racing heart, and dread warrant a medical check, and SADAG's Cipla line on 0800 456 789 can talk you through an attack.
Late sessions, adrenaline from close results, and worry about money keep the brain alert long after the last bet. About two in three people with severe gambling problems report at least one sleep complaint, with broken sleep and early waking among the most frequent. Keep the phone out of the bedroom, and log out of gambling apps well before bed.
Physical health can suffer, mostly through stress, poor sleep, and heavy alcohol use. People with gambling disorder die from any cause at about 1.8 times the expected rate, with heart disease as the main predictor. A GP check-up of blood pressure and heart health picks up early warning signs.
Smoking and gambling problems often go together. More than half of people in gambling treatment are dependent on nicotine, which makes it the most common condition that comes with gambling problems. Both habits respond to cues and quick rewards, so a smoke break can spark an urge to bet. Mention both to a counsellor, and one plan can cover the two.
Discussion, comments and your experiences
Share your opinion, ask a question or advise others. Editors reply as availability allows. For a quick response, use the chat.
Gambling and mental health in South Africa
Gambling and mental health problems tend to grow together. Low mood can push someone towards a bet that promises relief, and the losses, debt, and secrecy that follow drag it lower.
Depression, anxiety, suicidal thoughts, heavy drinking, and ADHD all connect to gambling in different ways. Each has its own route to help, and many free South African services treat both problems at once, whether the worry is your own gambling or someone else's.
Free help, 24 hours a day.
Call the National Responsible Gambling Programme (NRGP) on 0800 006 008 or WhatsApp 076 675 0710.
For thoughts of suicide, call the SADAG Suicide Crisis Helpline on 0800 567 567.
Gambling and mental health problems feed each other
Some people bet to take their mind off a hard day, and a match or a spin gives a few minutes of relief. Losses bring money worries, and the secrecy around them adds guilt. Both make the urge to bet stronger, so one problem keeps the other going.
The pattern holds in South Africa. Researchers surveyed 3,000 adults in the country's cities. People at risk of a gambling problem were more likely to struggle with depression, anxiety, alcohol or drugs.
Further afield, a 2025 review of population surveys from several countries shows how frequently specific conditions appear with gambling disorder.
Condition
Share of people with gambling disorder
Anxiety disorders
29.9%
Alcohol use disorder
27.8%
Drug use
22.5%
Major depression
20.3%
Bipolar disorder or manic episodes
18.6%
These conditions overlap, so one person may live with two or three at once. Because of that overlap, the psychological effects of gambling reach well past money, from broken sleep to constant worry.
Mood usually changes first, before any money trouble shows. Irritability and less time with family can be early warning signs of a gambling problem.
Depression and anxiety often follow losses
Heavy losses hit hard. After a run of bad bets, many people feel flat, ashamed, and unable to sleep, and they place another bet to win the money back. When that fails, their mood sinks lower and the next bet starts to look like the only fix.
Local treatment data show gambling and depression often go hand in hand. Among 200 South Africans in treatment for gambling, 28% had major depression at the time, and 25.5% had an anxiety disorder. Close to half had lived through depression at some point, and women showed higher rates than men.
Research can't always say whether gambling causes depression or the other way round, and gambling can cause anxiety as well, particularly once debts pile up or bets stay hidden from a partner. Because these shifts creep in slowly, keep an eye out for the following in yourself or someone close to you.
If any of these last two weeks or longer, book a chat with a GP or counsellor.
Suicide risk rises with gambling harm in South Africa
Gambling and suicide risk are linked, usually together with debt, isolation and other mental health conditions. If suicidal thoughts feel close to home, call South Africa's suicide helpline, the SADAG Suicide Crisis Helpline, on 0800 567 567, day or night.
The NRGP recorded 1,298 cases of suicidal thoughts linked to gambling in 2026, a 38.5% rise on the year before. About six in ten involved young adults aged 18 to 35.
Depression and suicidal thoughts often go together, so treatment for low mood is part of suicide prevention. Suicidal thoughts can pass, and people do get through them with support. Debt also looks less hopeless once a debt counsellor or a payment plan breaks it into manageable steps.
When someone you know may be at risk
Gambling debt can make a person feel trapped, and any talk of suicide needs a calm, direct response. Four steps help in the first hour, before professional support takes over.
Families need support of their own after a scare like this. Practical ways to help someone you love with a gambling problem can ease the pressure at home and keep the conversation open.
Alcohol, drugs and other addictions travel together
Alcohol lowers inhibition and blurs judgement at the exact moment a game swings and a bettor needs a clear head. Volunteers who drank alcohol bet more after a loss than after a win, while sober volunteers didn't.
In South Africa, the two can share a venue. Limited payout machines stand in pubs, taverns and other licensed sites, and the National Gambling Board counted close to 16,000 active machines at the end of March 2024. One drink beside a slot machine can turn into several bets.
Limpopo data puts a number on the link between gambling and alcohol addiction. Hazardous or harmful alcohol use came with nearly seven times the odds of high-risk gambling for 900 gamblers surveyed there. Awareness of the free gambling helpline was low, particularly outside the cities.
Cross addiction and process addiction
Gambling is a process addiction, which means the pull comes from an activity instead of a drug or drink. Shopping and gaming can hook people in the same way. Cross addiction is when one habit takes over from another, for example, when someone gives up betting and drinks more instead.
Swaps happen less often than many people fear. People are more likely to cut back on several habits together, though those who do swap face more severe problems. Tell a counsellor about every habit, and the plan can cover all of them.
For alcohol or drugs, South Africa's substance abuse helpline, a Department of Social Development service, also works as the national drug helpline and answers alcohol and drug calls 24 hours a day on 0800 12 13 14, or SMS 32312. SANCA operates treatment centres across the country and takes calls on 011 892 3829.
ADHD, bipolar disorder and some medicines can raise the risk
Certain conditions shape how the brain handles reward and impulse, which can make gambling harder to control. Three stand out in the research, each with its own warning signs.
ADHD and gambling addiction
ADHD brings impulsivity and a pull towards quick rewards, and in-play markets and fast games play straight into that. ADHD symptoms show a small but steady link with more serious gambling problems.
Across 36 studies of people in gambling treatment, about 9% had ADHD. SADAG also offers a dedicated ADHD helpline on 0800 55 44 33 from 8 am to 8 pm.
Bipolar disorder
Manic or hypomanic episodes can bring bursts of confidence and big purchases, and large bets can follow close behind.
People with bipolar disorder are about four times more likely to have a moderate or severe gambling problem than the general population. The risk climbs higher still when moods swing quickly.
Medicines that affect dopamine
Dopamine agonists, a group of medicines prescribed for Parkinson's disease and restless legs syndrome, can trigger compulsive gambling in some people. Among Parkinson's patients on these medicines, about one in six develop impulse control problems such as compulsive gambling, compared with roughly one in fifteen of the rest.
If gambling urges started or grew after a new prescription, raise them with the prescribing doctor straight away. A lower dose or a different medicine can settle them, and a supervised switch keeps it safe.
Withdrawal-like symptoms usually ease with time
The first weeks without a bet can feel rough, and gambling withdrawal symptoms are as emotional as they are physical. Around four in ten gamblers who try to cut down report withdrawal-like feelings, from anger to guilt and disappointment.
Those feelings can be intense. Problem gamblers rate their withdrawal about as severe as people dependent on alcohol do, and the worst moments cluster around familiar betting times.
Much of that anger and guilt traces back to what the bets used to cover, like stress, loneliness or a flat mood. Once you name the feeling, you can answer it another way, with a call to a friend or a walk. Put those swaps into a coping plan before the hardest weeks begin.
Deep hopelessness or thoughts of self-harm need urgent support. Ring the SADAG Suicide Crisis Helpline on 0800 567 567, any time.
Free help in South Africa covers both problems
Some services focus on gambling, while others cover mood, crisis or substance use, and each can point you to the next step. The 0800 numbers are toll-free.
Service
Helps with
Contact
Hours
National Responsible Gambling Programme
Gambling problems, for gamblers and families
0800 006 008, or SMS or WhatsApp "help" to 076 675 0710
24/7
SADAG Suicide Crisis Helpline
Suicidal thoughts and crisis support
0800 567 567
24/7
SADAG Cipla Mental Health Helpline
Depression, anxiety and other mental health concerns
0800 456 789, or SMS 31393
24/7
Lifeline South Africa
Trauma, emotional distress and relationship problems
0861 322 322
24/7
Substance abuse helpline
Alcohol and drug problems
0800 12 13 14, or SMS 32312
24/7
SANCA
Assessment and treatment for alcohol and drug dependence
011 892 3829, or WhatsApp 076 535 1701
Office hours
Last verified: October 2026
Free counselling in South Africa through the NRGP starts with a phone assessment, so mention mood, sleep, alcohol, or medication on that first call.
With the full picture, the counsellor can arrange support for both problems together, which clinicians call dual diagnosis care. Longer-term recovery may need professional treatment that treats gambling at the same time as depression, anxiety or substance use.
FAQ
Frequently asked questions.
Discussion, comments and your experiences
Share your opinion, ask a question or advise others. Editors reply as availability allows. For a quick response, use the chat.
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