To many, the stereotypical alcoholic is someone often visibly drunk or hungover. This person struggles with jobs, finances, and relationships, and engages in risky behavior. It is clear to most people they encounter that they have a problem. Their drinking has a significantly negative effect on their daily life.
While this is true for some people with alcohol use disorder, many others who struggle with alcohol don’t fit this stereotype. Some individuals are able to drink excessively while appearing sober or “normal” to others. They maintain jobs and relationships, and may even shine in these areas. Such a person is often termed a “high-functioning alcoholic.”
- What Is a High-Functioning Alcoholic?
- Characteristics of a High-Functioning Alcoholic
- How Do People Become Alcoholics?
- How Do You Know If You’re an Alcoholic?
- High-Functioning Alcoholics in Relationships
- How to Help a High-Functioning Alcoholic
Because alcohol has yet to cause them serious problems, high-functioning alcoholics often believe they don’t have a problem at all. Long-term, however, heavy drinking has certain inevitable consequences. For this reason, some experts use the term “currently functioning alcoholic” instead.
Are you concerned that you or someone you care about is a high-functioning alcoholic? This article will look at what the term means, how to recognize “problem drinking,” and what a person can do to change their relationship with alcohol, without putting their life on hold.
What Is a High-Functioning Alcoholic?
A high-functioning alcoholic is someone who meets the criteria for an alcohol use disorder, but shows few outward signs of it. They are seemingly able to maintain their career, personal life, and health.
Close friends and family may suspect that they have a drinking problem, but most people will have no idea. And although they may experience some negative impacts from drinking alcohol, it isn’t yet disrupting their everyday life. For this reason, high-functioning alcoholics may deny that they have a problem. They may believe they can “stop any time they want,” or control the amount of alcohol they drink.
Some of these individuals may drink moderately or steadily throughout the day. Others may remain sober during the day, then binge heavily on nights or weekends. But what all high-functioning alcoholics have in common is that they are drinking more than is safe for their health.
Characteristics of a High-Functioning Alcoholic
Aside from drinking more than the average person, what are some signs that someone is a high-functioning alcoholic? Here are some common characteristics of a person with alcohol use disorder (AUD), who is still “currently functioning”:
- They often drink more than others, and have difficulty controlling the amount they drink. For example, they consistently say, “I’m just going to have two drinks,” but continue drinking long after the first two.
- Drinking is a big part of their life; they may obsess over the next drink, or prefer social events involving alcohol.
- They joke about being an alcoholic or having a problem with drinking.
- Alternatively, they lie to cover up how much they are actually drinking, or make frequent excuses.
- They drink when they are alone, in the morning, or throughout the day.
- They rely on alcohol to cope with stress, feel confident, or self-medicate feelings of anxiety or depression.
- Drinking is sometimes used as a “reward.”
- They may occasionally struggle to keep up with responsibilities at school, work, or home.
- Sometimes they engage in high-risk behaviors, such as binge drinking, driving under the influence, or practicing unsafe sex.
- They experience blackouts, or forget what they did while drinking.
- They experience symptoms of withdrawal when they cannot drink. These may include mood swings, shaking hands, appetite loss, difficulty sleeping, sweating, headache, and nausea.
- Close friends and family members may notice some telltale signs, but aren’t yet worried enough to directly confront the individual. Overall, this person is perceived as “normal,” but may have a reputation for partying, or “knowing how to have fun.”
If someone has several of these symptoms, it’s possible that they are a high-functioning alcoholic. And although their alcohol use may not appear dangerous yet, it can certainly become that way.
Sooner or later, high-risk behavior associated with binge drinking can lead to injury, legal trouble, unplanned pregnancy, STIs, and so on. Chronic drinking can also cause or influence a number of serious health problems, including liver disease, heart disease, high blood pressure, pancreatitis, and even cancer. And that’s before addressing the impact of alcohol on mental health.
In other words, no matter how functional a person may seem at the present time, heavy drinking is very likely to cause them serious problems further down the line.
Speak with a Ria Health team member about how medication-assisted treatment can help you.
How Do People Become Alcoholics?
A variety of factors affect a person’s chances of developing alcohol addiction. Psychological problems like low self-esteem or depression, social factors like peer pressure, and genetics may all play a role. There’s no way to know for sure why one person who drinks alcohol becomes an alcoholic, and another does not.
However, scientists are beginning to understand the biology of addiction. Because our brains are wired for survival, they reward life-sustaining behaviors like eating and exercising. When we do these activities, they trigger brain circuits that release feel-good chemicals, motivating us to engage in the same activities again and again.
Unfortunately, drugs and alcohol can use these processes against us. They can trigger these same reward circuits, leading to cravings and addiction.
Substances like alcohol also increase anxiety and stress, once the pleasurable effects wear off. This, in turn, damages the prefrontal cortex, which is the brain’s decision-making center. These impacts on the brain, combined with the factors mentioned above, help create the dependency known as alcoholism, or alcohol use disorder.
How Do You Know If You’re an Alcoholic?
So, how do you know if you’re dependent on alcohol? There’s no quick and easy definition, or set number of drinks. But there are certain patterns of alcohol consumption that are cause for greater concern. These include heavy drinking, and binge drinking.
The CDC (Centers for Disease Control and Prevention) defines heavy drinking as at least 15 drinks a week for men, and 8 or more drinks a week for women. Binge drinking is defined as at least five drinks for men, and 4 or more drinks for women on a single occasion—usually within two hours or so.
If your drinking regularly falls into these categories, you may have alcohol use disorder. If not, these patterns still put you at higher risk for developing AUD at some point.
Signs of Alcohol Use Disorder
The Criteria for alcohol use disorder in The Diagnostic and Statistical Manual of Mental Disorders (DSM) include:
- Drinking more or longer than intended
- Trying to cut back or stop, but finding that you’re unable to do so
- Spending a lot of time drinking or dealing with the effects of drinking (physical side effects, hangovers)
- Craving alcohol
- Finding that drinking is causing problems with school, work, relationships, and other responsibilities
- Continuing to drink despite experiencing the above issues
- Giving up activities that were once important or enjoyable in favor of drinking
- Engaging in risky or dangerous behaviors
- Continuing to drink after blacking out, or realizing that it makes you feel depressed or anxious
- Finding that your tolerance for alcohol is increasing
- Experiencing withdrawal symptoms
Although even one of these symptoms can be a cause for concern, two symptoms within the same 12-month period is enough for a diagnosis of mild AUD. The more symptoms you experience within a year, the more severe the diagnosis of alcohol use disorder.
If any of these signs sound familiar to you, and you’re concerned you may be an alcoholic, you can also take our alcohol use survey. This quick quiz may help you determine if your drinking is a problem, even if you are still “high-functioning.” All results are confidential.
High-Functioning Alcoholics in Relationships
If you’re in a relationship with a high-functioning alcoholic, you may find that your significant other is secretive, and sometimes difficult to communicate with. You may also see some of the emotional side effects of alcohol use disorder, such as mood swings, anxiety, or depression. Your significant other may also seem to prioritize alcohol and partying over your relationship.
Living with a functional alcoholic often means you’re one of very few people who are aware of their drinking problem. While the disorder may be easier to conceal at work or in social situations, it’s harder for them to hide it from those closest to them. This experience can be very isolating, especially if your partner’s AUD contributes to conflicts within the relationship. If you find yourself in this situation, it’s important to take care of your own well-being.
Read more: 11 Signs You’re Dating an Alcoholic
How to Help a High-Functioning Alcoholic
If you decide to talk to your high-functioning partner or loved one about their drinking, you may find that they are defensive, or in denial. It’s important to have these conversations when they are not under the influence, and keep the focus on compassion rather than judgement.
Often, it helps to focus on how the drinking makes you feel or affects your relationship, instead of making statements about how the other person should be acting or living.
If they are open to making a change, help your loved one research their options. There are more choices than ever before, including telemedicine, and non-abstinence based treatment programs. And if they aren’t ready, be patient, and don’t put the blame on yourself. A person needs to be ready to change on their own. Their struggles with alcohol are not a reflection on you.
Read more: How to Help an Alcoholic
Recovery for High-Functioning Alcoholics
Since high-functioning alcoholics often lead active, busy lives, they are less likely to want to pause everything to attend rehab. They may also feel that alcohol isn’t a negative influence on their lives overall, and not want to stop drinking completely.
Fortunately, rehab and abstinence are no longer the only options. Medications for alcoholism can help some people relearn moderation, while online programs are making it easier to integrate treatment into your daily life.
Ria Health is one program that lets you access complete support, 100 percent from your smartphone. Members get weekly meetings with a recovery coach, online support groups, digital tracking tools, and much more—all discreetly, and on their own schedule.