How to Recognize a High-Functioning Alcoholic: Signs & Symptoms

More than 15 million adults in the United States struggled with an alcohol use disorder (AUD) in 2016, the National Survey on Drug Use and Health (NSDUH) publishes, which equates to more than  5.5 percent of the American population (age 12 and older). Alcoholism is a disease with far-reaching implications, negatively impacting families, work life, and society in general. It costs the American people around $250 billion annually when taking into account crime, health care costs, and lost workplace productivity, the National Institute on Drug Abuse (NIDA) explains.

Alcoholism does not look the same for everyone, however. In fact, there is a class of alcoholism called high-functioning wherein a person appears to have it together on the outside. High-functioning alcoholics likely have good jobs, are successful and productive, and have families and a seemingly stable home life. They are often highly educated, keep up with regular obligations, and don’t have legal or criminal issues related to drinking.

The New York Times reports that as many as half of all those battling alcoholism may be classified as high-functioning alcoholics, or HFAs. A high-functioning alcoholic is still battling the disease of alcoholism and, therefore, still at risk for many physical health, social, behavioral, occupational, and emotional issues related to problematic drinking and alcoholism in general.

SIGNIFIERS OF HIGH-FUNCTIONING ALCOHOLISM

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) publishes that doctors typically diagnose alcoholism, or AUD, when problematic drinking causes harm or distress. There are specific signs to look for. They include:

•  An inability to control alcohol consumption
•  Drinking alcohol in potentially risky situations
•  Continuing to drink despite knowing that it will have adverse side effects on health or well-being
•  Drinking that interferes with the ability to fulfill school, family, or work obligations regularly
•  Giving up activities for drinking
•  Legal issues
•  Physical dependence on alcohol, including difficult withdrawal symptoms when not drinking

A high-functioning alcoholic can typically hide issues related to alcohol from most people, however, and all of these signs may not be present or pertain to the person. Physical alcohol dependence may not be present in a high-functioning alcoholic, for example. They may be able to go days or even weeks without drinking and without suffering from serious alcohol withdrawal symptoms.

They are likely to spend a lot of time thinking about the next time they will drink, but it just may not be overt or shared with those around them.

Since many of the typical stereotypes, or even recognized signs, of alcoholism may not be visible in a high-functioning alcoholic, it can be hard to realize the extent of the issue, Psychology Today warns. Alcoholism is a potentially fatal disease, and even high-functioning alcoholics are at great risk for numerous possible issues related to drinking.

Some of the signs of a high-functioning alcoholic that indicate it is time to seek help include:

•  Living a kind of double life, drinking in private and functioning in public.
•  Drinking more in a sitting than intended, even after deciding to only have a set amount.
•  Making jokes about drinking or alcoholism, or just talking about alcohol all the time.
•  Frequent blackouts from drinking (not remembering what happened while drinking).
•  Drinking to relax or feel good, and drinking with every meal and social event.
•  Behaving in ways that are out of character when drinking. The sober self and drinking self tend to be very different from each other.
•  Hiding drinking and drinking alone. This may involve covering up drinking with breath mints or gum, and drinking before social events to keep it private.
•  A high tolerance for alcohol. The person can hold their liquor and drink a lot without seeming to be impaired.
•  Drinking instead of eating. Alcohol may commonly be a replacement for food.
•  Many excuses for drinking. The person may say they need to drink because of stress or to unwind, for instance.
•  An inability to stop drinking even if the desire to do so is there. They may have attempted unsuccessfully to quit drinking on numerous occasions.

WHAT TO DO WHEN ALCOHOLISM IS SUSPECTED IN A LOVED ONE

In many cases, it takes a major event to get a high-functioning alcoholic to recognize the hazards and implications of their drinking. It might be a DUI (driving under the influence), citation or arrest, a divorce due to an inability of a partner to continue to keep picking up the pieces and dealing with the fallout of the drinking, a botched project at work, significant health problems from drinking, or accusations of sexual abuse or misconduct related to intoxication.

Family members and loved ones often act as enablers in the case of high-functioning alcoholics, making excuses for their behavior and cleaning up their messes. It can be easy to make excuses for someone who seems to get things done, brings home a decent paycheck, and keeps up with most outward appearances. High-functioning alcoholics are often charming, social, popular, and successful.

Recognizing the signs of a drinking problem and the potential for high-functioning alcoholism in a loved one can aid in getting help before a major life-altering event. Contrary to popular belief, a person does not have to hit rock bottom to seek help. There are several things you can do once you realize a problem exists.

One of the first things is to stop engaging in enabling behaviors. Stop offering excuses for their behaviors to a boss or coworker, and stop cleaning up their vomit or tucking them into the couch at night when they black out.

A high-functioning alcoholic is likely to be in extreme denial, refusing to recognize that drinking is even an issue at all. This is partly because they can still function most of the time. It also makes it easier to give them a free pass on their drinking.

Alcohol is one of the top causes of disease and death worldwide, USA Today warns, killing close to 3 million people every year.

If someone in your life may be a high-functioning alcoholic, getting them help can literally be lifesaving.

GETTING ADDITIONAL HELP

It may help to enlist the help of a professional interventionist to schedule a structured meeting (an intervention) that can help you and other loved ones to address the problematic drinking and get the person into a specialized treatment program.

Private inpatient or residential programs can offer a high level of confidentiality and anonymity to protect a person’s privacy. They also provide a safe and stable environment to enhance overall wellness.

Regardless of the type of program you choose, it is essential to get professional help for high-functioning alcoholism. Even though it may seem like the situation is sustainable, continued alcohol abuse causes serious damage.

Sources

(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Retrieved November 2018 from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm

(April 2017). Trends and Statistics. National Institute on Drug Abuse. Retrieved November 2018 from https://www.drugabuse.gov/related-topics/trends-statistics

(May 2009). High Functioning, But Still Alcoholics. The New York Times. Retrieved November 2018 from https://www.nytimes.com/2009/05/05/health/05brod.html?_r=0

What are Symptoms of an Alcohol Use Disorder? National Institute on Alcohol Abuse and Alcoholism. Retrieved November 2018 from https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-Symptoms-Of-Alcohol-Use-Disorder.aspx

(January 2009). Why High-Functioning Alcoholics Need Help. Psychology Today. Retrieved November 2018 from https://www.psychologytoday.com/us/blog/the-high-functioning-alcoholic/200901/why-high-functioning-alcoholics-need-help

(August 2018). Alcohol Leading Cause of Death, Disease Worldwide, Study Says. USA Today. Retrieved November 2018 from https://www.usatoday.com/story/news/nation-now/2018/08/24/alcohol-death-disease-study-beer-wine/1082443002/

(January 2018). Drug Addiction Treatment in the United States. National Institute on Drug Abuse. Retrieved November 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states