Unlike more visible addictions, problem gambling is fairly easy to hide, yet nonetheless leaves about 2 million Americans annually feeling alone, ashamed and, in many cases, broke.

A recent survey from the National Council on Problem Gambling, a Washington-based nonprofit, showed that the risk has doubled since 2018. The survey of 2,000 people nationwide focused on attitudes and experiences gambling both online and at casinos.

In addition, the group’s helpline has seen a marked increase in use. Through November this year, the helpline received 238,600 calls, an average of nearly 21,700 per month. In 2018 and 2019, the average monthly calls hovered near 16,600.