The stereotypical view of an alcoholic is usually of someone who displays erratic, reckless and damaging behaviours and whose life is falling apart because they drink too much. So, when someone continues to work and maintain their financial and social obligations, they can’t possibly have alcoholism, can they?
Well, not all alcoholics are dysfunctional. Some are highly functional. There is a difference between someone who has high-functioning alcoholism and someone who enjoys drinking. The difference is addiction. However, for high-functioning alcoholics, a façade of normalcy often obscures the addiction issue.
The difficulty is spotting it, especially in cultures where alcohol drinking is socially accepted. You only have to look around you, whether in everyday life or popular movies or TV series, to see that talking business, relaxing, or celebrating isn’t properly done without an alcoholic drink. Seeing smiling people with drinks in their hands is the norm. Successful people share drinks with other successful people every day.
Signed the contract? – Let’s celebrate over a drink!
She says, “Yes, I do?” – Pop the cork!
Sealed the deal? – Drinks are on me!
Everyone enjoys a party, and a drink, and hangovers are just par for the course.
What is a high-functioning alcoholic?
While not a formal medical diagnosis, the term “high-functioning alcoholic” (or “functional alcoholic”) is commonly used to describe a person who has a drinking problem and is dependent on alcohol. They can still function as a member of society and continue to successfully manage their jobs, homes, and social life, only rarely missing out on important obligations due to their drinking.
An inward struggle often counteracts this outward appearance of being physically and emotionally healthy. A person may have alcohol cravings and fail repeatedly at attempts to quit drinking, thus increasing the likelihood of adverse effects from alcohol intake on their life and physical health.
How do high-functioning alcoholics go under the radar?
In most Westernised cultures, high-functioning alcoholics are rarely called out. Whoever says, “Stop it! I think you’re becoming an alcoholic”? The negative realities of drinking and alcohol use disorders (AUD) rarely get serious screen time. When they do, it is usually a portrayal of poor stereotypes – drunks on park benches, or a person who lacks personal hygiene and cleanliness, abandoned by friends and family, and unable to stay in a job, much less walk in a straight line.
The truth is alcoholism exists on a very long and broad spectrum of severity, and it cuts across all genders, ages and sections of society.
How widespread is the problem?
While there has been no official declaration that high-functioning alcoholism is an epidemic, the growth rate of clinics in the addiction recovery field tells a different story. Functioning alcoholics exist in considerable numbers. And increasingly, there are private clinics offering specific treatment programmes for executives, such as the hybrid programme at NEOVIVA, which enables people to continue with their professional responsibilities while seeking treatment.
One American study on AUDs estimates that about 20% of people who meet the diagnostic criteria for an alcohol use disorder appear to others to be highly functioning people. Other studies suggest that up to 75% of those with AUDs are able to function at a high level in many areas of life. High-functioning alcoholism is widespread, and there are damaging consequences.
The signs: how to recognise a high-functioning alcoholic
Identifying high-functioning alcoholism can be difficult, especially given the legality of alcohol, its easy availability, and the widespread acceptance of drinking socially and culturally. Even in countries where alcohol is banned, the problem of high-functioning alcoholism exists. Illicit alcohol production and consumption still goes on.
Certain behaviours may indicate that a person is a functioning alcoholic. Here are some of the critical signs to look out for:
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Regular drinking with a high tolerance
For some people, there is always a reason to drink. High-functioning alcoholics will always justify it as a reward, a celebration, or to wind down. There is a work event, a lunch with a visiting colleague, coping with a stressful situation, being glad the long workday is over, needing to unwind before going to sleep, celebrating the weekend … the list goes on.
In addition, they rarely appear to be drunk or suffer from hangovers. This happens because a high physical tolerance to alcohol has been built over time. Figures from the US National Institute on Alcohol Abuse and Alcoholism put the amount of drinking into perspective. It determines that “heavy drinking” is defined as consuming more than seven drinks per week (for women) or more than 15 drinks per week (for men).
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Secretive and deceptive behaviour
High-functioning alcoholics will often try to conceal their alcohol consumption, lie about their whereabouts or play down their drinking habits. They may hide alcohol around the house, in the car or garage, or be insistent on getting a drink before an event where alcohol isn’t available. Increasingly, they may drink alone, secretly, or at unconventional times.
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Being defensive or avoiding criticism
When confronted with other people’s opinions about their drinking habits, functioning alcoholics often show signs of uneasiness. Responses range from flippant and self-ironic remarks to mocking, blaming external factors, or downplaying any concerns with excuses. They may even become angry if forcefully challenged about their drinking habits.
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Denial
Almost all high-functioning alcoholics tell themselves they don’t have a problem. They go to work every day, pay their bills on time, have a loving home and have fun with friends. In their eyes, they don’t need help because they have their drinking under control. To them, it’s not an issue.
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Making a joke of it
Occasionally, you’ll come across a high-functioning alcoholic who is open about it and makes a joke of it. When asked, “Do you drink?” Famous writer Stephen King,” supposedly said, “Of course, I just said I was a writer.” They imply it’s not an issue, that it comes with their professional territory, and that they have complete control over it.
Who is susceptible to high-functioning alcoholism?
Alcoholism does not make a distinction between gender, background or financial status. There are many reasons why people may develop an AUD, but there are shared risk factors that can increase a person’s chances of developing a drinking problem. These include:
- High levels of stress
- Peer pressure to drink
- Having friends or family members who suffer from an AUD
- Suffering from low self-esteem
- Existing mental health problems, such as anxiety or depression
The risks associated with alcohol dependency
- Health complications: chronic alcohol use can lead to liver disease, heart problems, and cognitive impairments
- Emotional strain: dependence on alcohol may result in anxiety, depression or mood swings
- Relationship issues: alcohol misuse can cause conflicts, erode trust, and lead to isolation from loved ones
- Professional consequences: while initially manageable, eventually, alcohol dependence can impair performance
Other signs that a person may suffer from an AUD
- Memory blackouts
- Extreme mood swings
Confronting a high-functioning alcoholic
As denial plays a powerful part in being a high-functioning alcoholic, by the time they do admit their problem, withdrawal symptoms such as anxiousness, depression, nausea, or tremors might have become severe enough that they keep drinking primarily to avoid those symptoms – and thus the downward spiral of addiction continues.
Early intervention can be key in preventing the problem from intensifying further. So, if you recognise that someone needs help or believe a person is showing signs of being a functioning alcoholic, you may wonder how best to give support.
Firstly, it is essential to approach the person sensitively about their behaviour and the impact of their alcohol use. Choose a private environment and the right moment for this frank and open conversation, taking a walk together or having a coffee when no one else is around. Ensure the person you are worried about is sober when you speak with them.
Secondly, avoid accusatory or judgmental tones. Simply saying, “You are drinking too much!” will likely elicit a defensive response. Your goal is to show that you are trying to help and to convince the person to seek treatment. Stay assertive and emphasise your concern. Use “I” statements, e.g., “I am worried about you” or “I’ve noticed you seem stressed lately and are drinking more than usual.” Statements that aren’t blaming will have far more sway.
Finally, don’t expect too much or even a reversal of their behaviour following your first talk. Expect them to make excuses, remain in denial, or even attack or insult you. Stay calm and patient when explaining the consequences of their alcohol use and how it is negatively impacting other people’s lives. This will put the problem in perspective for them, helping them to reflect on the consequences of their behaviour.
If you choose a gentle approach, the person may already be aware of drinking too much and is more likely to listen to your wake-up call. Don’t expect them to change instantly. The first hurdle is to sow a seed, and at the very least, they will have been alerted to the fact that their behaviour has not gone unnoticed. If they are willing, assist in finding more information or resources, such as support groups or treatment.
Treatment for high-functioning alcoholics
Stepping out of denial is a crucial step. Treatment facilities, such as NEOVIVA, offer treatment programmes to help stop the cycle of alcohol addiction. If you or someone you know is unable to stop drinking on their own and you want to reach out for help, you can contact us directly. We are ready to help and talk you through our personalised treatment programmes.
Remember, high-functioning alcoholism is a serious condition. If left untreated, it can lead to severe health and personal consequences.
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