High Functioning Alcoholics

Alcoholism can have devastating effects on a person’s life. It can ruin our physical health, emotional well-being, professional career and even our personal relationships.

However, there are alcoholics who can manage this habit and function effectively in society. They run businesses, hold down jobs and maintain households. They are good at hiding their alcohol abusive lifestyle for many years, without experiencing any major drawbacks. Some might even retain top positions as pillars of society.

Unfortunately, beneath the ‘normal’ exterior, this form of alcoholism poses severe consequences to one’s psychological and emotional well-being. Eventually, the damage takes its toll and in turn, affects the ones we care about.

There are basically two classes of alcoholics:

  • Functioning alcoholics
  • Alcoholics who struggle to maintain a regular lifestyle

If you care about somebody who falls into either category, it’s helpful to know how to cope with the situation effectively. You’ll need to consider the symptoms and effects it has on their lifestyle – especially if you want them to get better. Knowing how to cope with an alcoholic is also critical in helping them get the right treatment.

Functioning alcoholics differ from struggling alcoholics, mainly in the way their drinking habit affects their lives. You may be wondering how you can help if your spouse or partner is an alcoholic. Many people unwittingly enable loved ones who are alcohol-dependent. While it’s good to provide love and care, it’s important to avoid enabling them or they won’t be able to quit.

By acting quickly, you can avoid exposing yourself or a loved one to the dangers of high-functioning alcoholism.

What is a High-Functioning Alcoholic?

When you hear the term ‘alcoholic’, perhaps the first image that comes to mind is that of an unkempt person whose life is in disarray. However, not every alcoholic fits into this stereotype. There are alcoholics who appear to have everything working out well for them.

The category of people – known as ‘high-functioning alcoholics’ – drink too much, but also manage to excel in their careers and even maintain good relationships with their family and peers. Their successful lifestyle is often misleading because it allows them to think they have their drinking under control. Even other people (who may be able to help) usually fail to see that they have a problem. Unfortunately, though it may take years, the consequences of their habits catch up with them and it can be very distressing.

If you’ve been thinking about an alcoholic in terms of the age-old stereotype, now is a good time to review your mindset. There’s a chance you could be missing the signs in someone close to you – or even yourself.

High-functioning alcoholics are often in denial of their condition and as such don’t take any actions to find a solution. This is even more dangerous, as they may continue the habit until a severe health problem ensues.

The first step to getting help is recognising the signs while it’s still early. However, this can be difficult, since they are not as obvious as when displayed by a stereotypical alcoholic.

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Why Is It So Difficult to Recognise?

A recent survey showed that many people fit into the category of ‘severe drinking’, whilst appearing to be perfectly healthy beings with highly functioning lives from the outside looking in.

Like all addictions, alcoholism is deceptive. It makes the abuser believe that nothing is wrong and that they’re perfectly normal.

Ultimately, some people can apply their

knack for organisation to their drinking habits and balance it with their general lifestyle. Though the heavy drinking may seem under control, the danger is inherent and will come to the surface sooner or later.

Another reason many people fail to recognise the signs is that of our stereotypical viewpoints. Poor awareness of this condition means that several people still regard alcoholics as the angry man at the bar or the homeless, incoherent woman on the street. Not many people think to suspect the healthy-looking professor in their lecture hall.

In fact, research has shown that only one in ten alcoholics are homeless or otherwise extremely ‘low functioning’. Where there’s some level of material security, a sound reputation or inconsequential penalties for addiction present, high-functioning alcoholics will more likely be in denial and believe they can bypass treatment by dealing with it ‘in their own time’.

There is no such thing as a “good alcoholism” or someone who can manage their already present dependence on alcohol. Being able to continue living in a state of relative normality also increases the chances of blocking your mind from the truth about your addiction.

The effects on family and close friends are concealed

The story of a high-functioning alcoholic is essentially about appearance; the evident trappings of success mask a bigger problem, disguising its impact on everybody except the closest and most intimate members of their circle.

High-functioning alcoholism may not necessarily mean that the alcoholic’s family becomes insolvent or deals with alcohol-related violence. However, it greatly affects the emotional side of things, creating unhealthy balances, as well as the fact that people outside the close-knit circle of loved ones around the one suffering with alcoholism never really know what is going on.

Due to the projected success of a high-functioning alcoholic, their family members are usually reticent to confront them about their problem drinking. Even in situations where emotional issues create deep rifts within the family, loved ones can be fearful to voice their opinions, because they think nobody will believe them.

It’s not uncommon to hear people say, “I don’t want them to be embarrassed” or “They seem okay on their own, so there’s no reason for me to complain”. The situation is also concealed from outsiders, because of the outward appearance of a “happy family”. Subsequently, it becomes even harder to perceive the truth.

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Work and school: Enabling the high-functioning alcoholic

Many high-functioning alcoholics are ‘protected’ by the complicity of the pervading culture. In some societies, heavy drinking is associated with certain economic statuses. Most successful people are less likely to question – or be questioned – about their drinking habit, hence their addiction remains unrecognised.

For example, most people believe that frequently drinking wine or hard liquor is fairly normal behaviour for wealthy aristocrats. It’s perceived that there is always a mini-bar filled with decanters and drinks nearby, whether at home, in the office or at the clubhouse.

This light-heartedness with which we take the constant presence of alcohol is what concerns many specialists. Easy access often creates a dependence on unwanted behaviours and/or substances.

Another example where this is seen as the norm is in university circles, where undergraduates prove their strength and position in the campus society during heavy drinking episodes.

These places are less likely to question whether one’s alcohol consumption is excessive or not. The false impression that addiction is ‘obvious’ makes it easy for ‘non-obvious’ types to thrive, or suffer, in plain sight.

According to a New York Times article, many bosses are well-camouflaged high-functioning alcoholics because they are neither supervised nor will be questioned about their drinking patterns. Business appointments are often held at restaurants where a bottle of wine is more than natural to order, while most CEOs hold a mini bar at hand in their offices.

Stages of Alcoholism for the High-functioning Alcoholic

If you are a high-functioning alcoholic, it’s easy to distance yourself from the term ‘alcoholic’, especially when you see other abusers who’ve not been as successful in hiding their habits from others. Alcoholism is a progressive disease – it worsens over time.

Some people compare addiction to cancer because nobody deliberately decides to have cancer, much the same way no one decides to become an alcoholic. In addition, both diseases feature stages of progression and require professional treatment.

The following are the four stages of alcoholism in the functioning alcoholic:

Stage 1: Binge drinking and increased tolerance

When you drink, do you intend to get drunk?

This question may sound strange, but it is relevant to the topic. The average drinker (who is not alcohol-dependent) doesn’t drink to get intoxicated. Most average drinkers don’t like the thought of losing control or the feeling of oblivion. However, someone who is alcohol-dependent doesn’t worry about this and continues to drink until they can’t any longer.

High-functioning alcoholics continue to consume more alcohol in one drinking session. This is otherwise known as binge-drinking. It is typically defined as the act of consuming a large quantity of alcohol within a short period of time. For men, the limit set by the Government as a healthy intake is six units, while the threshold for women is four units.

At the end of a binging session, the blood-alcohol concentration will usually be 0.08g/L or more.

As you drink more, the brain adjusts its structure and chemistry to accommodate the effect of alcohol on the receptors. After a while, you’ll discover you can drink more than you used to, without becoming intoxicated. This is known as tolerance, which usually gives way to dependence.

Stage 2: Drinking as a coping mechanism

Do you drink to feel better?

We all experience one issue or another from time to time, but it’s the way we deal with it that matters. A high-functioning alcoholic usually drinks either to cope with stress or to celebrate success. Do you consider drinking after a long day at work common? If so, you may be a high-functioning alcoholic.

You may be imagining that the only way to overcome a problem is by drinking. If your workday is not going as planned, do you find yourself anxious to clock-out and visit a pub? You maybe consider Fridays as the best part of the week because you can binge-drink all evening. And it’s not even socially unacceptable.

Over time, you may begin to believe that there are no coping methods for stress or pain, other than alcohol. You might not exhibit dependence symptoms such as morning tremors, and you may even attend work as usual. It’s easy to think that all is well during this period, but this usually leads to a worsening of the situation.

Stage 3: Isolation, legal issues and depression

Are the consequences beginning to show?

At the third stage, life revolves around problems and consequences, as well as how to manage your drinking. You do not want to let things as out of control. In this category, some people might begin to question your drinking at some point. They will begin to observe certain changes in your lifestyle and some might withdraw, stop socialising with you. Problems vary with each individual, but the following consequences are common:
Isolation: People will start feeling uncomfortable when you drink around them. Friends and family will express concerns about your drinking and worry that you may even drive in that state. You‘ll often forget certain things that they discussed with you. Eventually, you’ll grow weary of their discomfort and start avoiding them.

Legal issues: By this time, a functioning alcoholic will probably receive their first DUI. If you’re legally unable to drive, you will most likely resort to drinking at home. Even if you haven’t been caught driving under the influence, it’s dangerous to continue driving whilst drunk.

Depression: By this time, the reality will hit hard. Alcohol works like a depressant in our mind and body; people who are dependent can feel empty and lonely when they don’t drink. This is more likely to be the case if you drink as a coping mechanism for pain or stress.

It’s easy to feel like a functioning alcoholic at Stage Three because you‘ll likely still be employed – even though you may have changed jobs a couple of times. Your relationship will still be intact, though it might not be what it was previously. However, the alcoholic is only ever one stage away from imminent danger.

Stage 4: Change in looks, high blood pressure and health problems

How does your body look or feel?

In this final stage, your body will be different. Most alcoholics at this time will hardly recognise themselves in the mirror because their appearance will have changed – from a flushed skin to a distended stomach or ‘beer gut’. A doctor will express concerns about high blood pressure, stomach ulcers or heartburn.

Stage-four alcoholics tend to be worried at night, as they might not have a sufficient supply of alcohol to sustain them before the shops close. This is an indication of outright dependence.

It’s easy to think you are high-functioning at this stage because you manage to leave for work each morning. The thought of still earning a paycheck can be misleading, and there are certain lingering questions: how productive are you? If you have a family, are you there for them? If you are in a relationship, how strong is your bond?

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15 Signs and Symptoms of a Functioning Alcoholic

You can avoid being entrenched in the grip of alcoholism and help someone receive proper treatment while it’s still early.

A functioning alcoholic may not show visible signs of dependence, and their lifestyle may still be intact, but it’s not impossible to recognise one if you know what to look for.

There are certain signs and symptoms that may give them away. If your spouse, sibling or friend is struggling internally, you might be able to help them. Before we list the signs, it’s important to know the risk factors for alcoholism. They increase a person’s likelihood to be alcohol-dependent.

Common risk factors for alcoholism include:

  • A history of traumatic experience
  • Biological brain defect (or injury)
  • Peer pressure
  • A reckless personality
  • Family history of alcoholism (genetics)
  • History of other substance abuse
  • Presence of an underlying disorder (dual diagnosis)
  • Early drinking behaviour from teen years

If someone with any of these factors shows definitive signs of alcoholism, there’s a high chance they might be dependent on alcohol.

They would rather drink instead of eating: High-functioning alcoholics prefer to drink before anything else; at a gala or social event, they will be more interested in the drinks than the food. They usually use meal times as an excuse to resume drinking.

They exhibit sudden changes in behaviour whilst drinking: High-functioning alcoholics tend to behave unpredictably when drinking. They can be calm and friendly one minute, then mean and erratic the next. They are also very active in every round of drinks – in a bar or at any other social hangouts.

They never have just one drink: Some drinkers tend to be content with one drink and some may occasionally decline. However, high-functioning alcoholics are never satisfied with just one drink and you’ll rarely see them refuse an offer. They might also finish other people’s drinks at the table.

They frequently blackout from drinking : It is not uncommon for them to forget the activities of the previous night. Alcohol tends to impair one’s memory, so they might not recall dancing wildly at the bar or following a stranger home. This is because they tend to blackout after a night of heavy drinking.

Most of their jokes have an alcohol punchline: Most high-functioning alcoholics never miss an opportunity to joke about their drinking habit. If you all need to leave a place suddenly, they might say things like, “Wait, we can’t let this fine liquor go to waste” or may describe themselves as “drinking enthusiasts”.

They always feel the need to explain their drinking: Alcoholics who are guilty about their drinking will often try to rationalise their actions. For example, they may chalk up their pre-noon whisky shot “to counter stress at work” or to calm themselves when boisterous children are charging around the home.

They hide their alcohol: High-functioning alcoholics who don’t want to explain their penchant for alcohol may sneak a drink or two when no one is looking. Others may do so in plain sight, like spike their coffee with a few shots of whisky. They will also have secret stashes in various parts of the home.

They may feel some shame about their behaviour: Because hiding is a major aspect of their addiction, functioning alcoholics will feel remorseful or ashamed of their behaviour. The guilt can make them trash vessels containing liquor, only to resume later with another bottle from one of their secret stashes.

They usually lead a double life: The high-functioning alcoholic tends to separate various sections of their life. The person you know at work will differ significantly when you encounter them in a social setting. Their drinking personality is almost the opposite of their regular ‘business’ persona.

They drink alone: Addiction is a disease of isolation. Because many other people are uncomfortable with their drinking habits, the high-functioning alcoholic will resort to drinking alone at the bar or at home. Isolation is a gateway to other alcohol-related problems.

They mix their drinks: Many long-term alcoholics have built tolerance over the years. Their reaction to plain alcohol can be ineffective, so they tend to mix various drinks from vodka to whisky, gin, schnapps and so on. However, mixing drinks has the potential to cause alcohol poisoning.

Attempts to discuss their drinking are met with anger: If you confront a high-functioning alcoholic about their drinking habit, they may lash out in anger. Aggressive behaviour is a common sign in alcoholics and stems from their lack of control whilst under the influence. Any confrontation or discussion about drinking must be carried out when they are relatively sober.

They are often in denial of their problem drinking: When they do discuss their habit, functioning alcoholics are likely to insist that they’re doing fine, and their drinking is not a problem. Denial makes it difficult to provide help or get treatment, so it’s important to contact an intervention specialist if you are planning to intervene.

Forgetfulness and tendency to lose control: High-functioning alcoholics may look calm and collected on the surface, but there are occasional lapses in their behaviour. From forgetfulness to apathy and panic, they tend to reveal certain mental disturbances as the psychological/emotional pressure builds up.

Attempts to quit are always met with failure : It’s always a good sign if you or someone you know admits to having a drinking problem. However, trying to quit solo is hard and many find it unbearable without professional treatment. High-functioning alcoholics who believe they can quit by simply getting rid of their bottles are usually surprised to discover how hard it is.

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What It’s Like to Be a High-Functioning Alcoholic?

The high-functioning alcoholic is aware of their problem, but they diminish its severity because they believe their life is going just fine. However, they’ll do what they can to keep it a secret. Over time, alcoholism takes its toll on a person which few may never know about.

It’s believed that there are over 18 million alcoholics in the US and 20% of those are high-functioning. In the UK, there were 1.1 million estimated reports of hospital admissions due to alcohol consumption.

High-functioning alcoholics will hardly acknowledge that they are problem drinkers, as they aren’t experiencing the negative consequences yet, just the reward. The truth is that no matter what kind of an alcoholic a person is, they will eventually feel the effects of their substance abuse behaviour. The longer it takes, the more severe it will likely be.

As a functioning alcoholic, you may find yourself doing things you normally wouldn’t, just for the sake of alcohol. For instance, you might drive all the way to a bar on the other side of town just to avoid familiar faces. You could even miss your child’s school play because of a hangover. Yes, alcoholism is not just the effects you experience while being drunk, but also the side-effects this has on you – hangovers, debts, health issues, etc.

If you want to know how severe your drinking problem is, an alcohol assessment test is a good place to begin.

What is an alcohol assessment test?

This is a quick test to determine your level of dependency on alcohol. An alcohol assessment test may be a self-evaluation, in which case you’ll answer 10 – 22 questions, depending on the type of test. Some can be taken online, while others may require a specialist’s help.

Employers, courts and schools may request a more comprehensive assessment test. These authorities need them to make important decisions regarding a person’s alcohol consumption habits.

Although online tests such as CAGE, AUDIT and MAST offer a preliminary insight into your drinking behaviour, they are not conclusive diagnostic tools. For more in-depth analyses, visit a proper alcohol addiction clinic. A blood and urine sample test may be carried out for good measure.

Alcohol assessment tests can be used to determine the next line of action for addiction treatment and prepare a safe procedure for detoxication.

Dealing with the Problems of High-Functioning Alcoholics

If you are involved with a high-functioning alcoholic, you’ll understand how difficult it is to live with this ailment. By getting help for yourself or loved one, you’ll be able to avoid the risks of alcoholism and live a healthier, more fulfilling life with your family.

The first step is to recognise the warning signs. High-functioning alcoholics will rarely agree that they have a problem, but if somebody you care about consumes more than three to four alcoholic beverages every day, that person is exceeding the recommended healthy limit. You can also use the above-listed signs and symptoms to confirm your suspicion.

Avoid falling into the co-dependence trap. As a spouse, parent, brother, sister, friend or partner of an alcoholic, it can be difficult to avoid enabling them. However, this will only make it worse. Enabling is the act of indulging a person’s substance abuse behaviour by failing to get help, but instead providing more alcohol or helping manage issues relating to their addictive behaviour.

Examples of enabling include making excuses for them, paying their bills, buying groceries and other responsibilities. If they don’t get the proper help, they will never get better.

If you’re sure that a loved one is a high-functioning alcoholic, approach them with your concerns. This could be a very sensitive topic, so do so with caution, preferably when they are sober. You can ask an intervention specialist to stage a family intervention. The goal is to get them to admit their problem and enter rehab for treatment voluntarily.

Even whilst they are in rehab, care doesn’t end there. Endeavour to provide support for their full recovery. Help them find an Alcoholic Anonymous (AA) meeting, listen to what they have to say and generally be there for them. Sobriety is an ongoing exercise.

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The Challenges of Helping High-Functioning Alcoholics

It’s difficult to persuade high functioning alcoholics and addicts to get treatment, and they also pose unique problems when they check into rehab. The following are some challenges to expect when dealing with a high-functioning alcoholic:

Work/busy schedule: Many high-functioning alcoholics are star performers at their place of work. As inpatient rehab treatment might be required over an extended period, they will most likely reject this idea of residential care. Resolve this by convincing them to take a break. Typically, most employers wouldn’t want to lose their talented staff, so should be willing to grant them a recovery period.

Enabling: As discussed before, one of the major challenges of having a relation or friend who is an alcoholic is the tendency to indulge them. Love plays a very strong role here; you may be tempted to buy alcohol for them or even make excuses to cover the truth. This action only allows them to sink deeper into addiction. Practise some tough love and help them get proper treatment by remaining steadfast.

Denial: Denial is one of the biggest challenges you’ll encounter when talking with an alcoholic. For one, they appear in control of their life, so they will reject any notion that they have a drinking problem. Get a skilled interventionist and an experienced treatment service to convince them.

Success/Ego: Most high-functioning alcoholics have a big ego because they’re most likely successful people and have also succeeded in combining a drinking problem with their busy schedule. Due to the stigma attached to the term ‘addiction’, they will refuse to listen to anybody. To resolve this, a professional counsellor must tackle the underlying problem of fear, because most egos are fear-based.

Lies Told about High-Functioning Alcoholics

The term ‘alcoholic’ can be misleading. It often paints the picture of someone who drinks too much and can’t ‘hold their own’. Unfortunately, high-functioning alcoholics break that stereotype. The following are common lies we have often heard about alcoholics:

“Alcoholics cannot keep jobs or be successful”: Many alcoholics occupy top positions and are able to maintain their jobs – at least for some time.

“High Functioning alcoholics are always in control”: Not always. Eventually, the psychological and emotional pressure may catch up to them and cause crashes in both career and relationships.

“High Functioning alcoholics don’t show signs of alcoholism”: They do, but not as obviously as typical If you know where/how to look, such as the ones we described, you will see the red flags.

“High functioning alcoholics don’t need help”: If anybody needs help most, it’s alcoholics in this category. Any addiction that goes under the radar poses the worst kind of risks. If you know any high-functioning alcoholics, please, help them find treatment.

Facts and Statistics about High-Functioning Alcoholics

  • Alcohol is one of the major substance abuse problems in the UK and around the world. A recent study revealed that America had 18 million alcoholics and 20% of them were high-functioning.
  • In another study, it was revealed that 30% of high-functioning alcoholics have a genetic history of alcoholism and about 25% suffer serious depression at some point in their lives.
  • In the same study, about 23% of adult men reportedly binge-drank five times a month; that is an average of eight drinks per episode.
  • For women, about 12% admitted to binge-drinking three times a month, amounting to an average of five drinks per episode.

Frequently Asked Questions

What is a “wet brain”?

Wet brain is a type of brain damage. Also known as the Wernicke-Korsakoff syndrome or Korsakoff’s psychosis, it is often caused by long-term, heavy alcohol consumption, which can deplete levels of thiamine in the body.

Am I a high-functioning alcoholic?

If you depend on alcohol to function normally and are still able to hold down a job, manage your family or a relationship without issues, then you could be a high-functioning alcoholic. However, over time, the psychological effect of this condition could affect your career and relationships.

What is a functioning alcoholic?

This is an alcoholic who, despite their dependence on alcohol, has managed to be somewhat successful in their career, and manages his or her lifestyle without the visible problems associated with general alcoholics.

Why is it so difficult to recognise?

We have been conditioned to view alcoholics as people who are always drunk, homeless or live shambolic lifestyles. Because of this, many high-functioning alcoholics exist in plain sight, without drawing much attention. Some family statuses and workplace/school cultures also make it difficult to recognise the condition.

Is being a high-functioning alcoholic bad?

Yes, it is. The danger is that the individual believes they are in control and can quit whenever they want. However, they rarely do. Instead, they tend to develop psychological emotional problems later in life. The deceptive nature of HFA addiction also makes it difficult for family and friends to identify a struggling loved one and provide help for them.

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