Theo Nash
Despite the outward appearance of success, high-functioning alcoholism can have severe consequences for the individual's physical health, mental well-being, and relationships. High-functioning alcoholics may be in denial about their addiction, as they have avoided the negative consequences typically associated with alcohol misuse. However, this form of alcoholism can cause severe psychological and emotional damage to the alcoholic and their loved ones. Recognising the signs of high-functioning alcoholism is crucial, as it can be challenging to identify due to the individual's ability to maintain a facade of normalcy and control.
| Characteristics | Values |
|---|---|
| High-functioning alcoholics can excel in their professional and personal lives | --- |
| They can be hard to identify | --- |
| They can be in denial about their problem | --- |
| They can be high-educated with good incomes | --- |
| They can be well-versed in hiding their addiction | --- |
| They can be anxious, depressed, angry, and preoccupied with their next drink | --- |
| They can experience significant personality changes when drinking alcohol | --- |
| They can be at risk of developing alcohol-related physical or mental health complications | --- |
| They can be more likely to socialize with others who drink | --- |
| They can experience withdrawal symptoms when they stop drinking | Nausea, headaches, fatigue, shaking, shivering, and vivid dreams |
| They can put themselves or others in danger by drinking and driving, having risky sexual encounters, or blacking out | --- |
| They can be more likely to suffer from liver disease, pancreatitis, some forms of cancer, brain damage, serious memory loss, and high blood pressure | --- |
| They can be more likely to die in a car wreck or from murder or suicide | --- |
| Their addiction can negatively affect their loved ones | --- |
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What You'll Learn
Difficulty recognising the problem
Functioning alcoholics may appear to be in control and effectively living a double life, as they seem highly functional on the outside but are anxious, depressed, and preoccupied with their next opportunity to drink on the inside. They may be high achievers or in positions of power, and their success may lead people, including themselves, to overlook their drinking as a problem. This level of denial can be challenging to overcome and may prevent loved ones from getting through to the functioning alcoholic.
The gradual toll of addiction can be difficult to identify, as functioning alcoholics may not exhibit the full range of clinical impairments commonly associated with alcohol use disorders (AUD). They may perform well at work, have a pristine appearance, and enjoy an active social life, all while secretly battling an addiction. This facade of normalcy can complicate the identification of their condition and make it challenging for them and those around them to acknowledge the existence of a problem.
The high tolerance for alcohol often exhibited by functioning alcoholics further obscures the issue. They can consume large amounts of alcohol without appearing intoxicated, and their bodies have adapted to the regular intake, requiring more alcohol to achieve the same effects. This increased consumption can lead to serious health complications over time, but the connection to drinking may not be immediately apparent.
Early recognition of the signs of functioning alcoholism is crucial to prevent adverse outcomes and pave the way toward recovery. Intervening early can help prevent the development of further alcohol-related physical or mental health complications and address the underlying issues driving the alcohol abuse.
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Health risks
Despite maintaining a facade of normalcy, high-functioning alcoholism can have severe health consequences over time, impacting physical health, mental well-being, and relationships.
Physical Health Risks
High-functioning alcoholism can lead to a multitude of physical health issues, including:
- Liver disease (cirrhosis, fatty liver), and liver damage
- Gastrointestinal problems
- High blood pressure
- Heart disease
- Increased risk of certain cancers
These risks are not diminished by one's ability to perform well at work or maintain a steady income. It can take many months or years for these health problems to manifest, but once they do, they can turn into chronic and life-altering issues.
Mental Health Risks
Alcohol is a depressant that affects brain chemistry. Over time, chronic use or dependence can exacerbate mental health problems, including:
- Depression
- Anxiety
- Mood swings
- Irritability
Relying on alcohol as a coping strategy can worsen psychological distress and create a cycle of dependence that is challenging to break without professional intervention. High-functioning alcoholics may use alcohol to cope with stress, anxiety, and other uncomfortable emotions. This coping strategy can result in a cycle of dependence, exacerbating existing problems and leading to further emotional distress.
Other Health Risks
High-functioning alcoholism can also impact other areas of an individual's health and well-being:
- Academic and Professional Life: Despite their ability to maintain outward appearances of success, consistent alcohol consumption can lead to decreased motivation and poorer performance. High-functioning alcoholism may result in increased absenteeism, accidents, and lost productivity in the workplace, as well as lower academic achievement.
- Blackouts and Memory Lapses: High-functioning alcoholics may experience blackouts or memory lapses, where they are unable to recall events that occurred while they were drinking.
- Relationship Strain: Alcoholism can put a strain on personal relationships and lead to a slow erosion of emotional well-being.
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Impaired judgement
Alcohol impairs judgement and can lead to poor decision-making. Even a small amount of alcohol can affect a person's judgement, and this can be difficult to recognise and easy to overlook. A study by San Diego State University found that decision-making is affected before motor skills, and that even one serving of alcohol leads to a decrease in reaction time.
Neuropsychological studies have shown that alcohol dependence is associated with impaired executive functioning, including working memory, planning, and flexibility. This can constrain the possibilities of flexible changes of action strategies, reduce behaviour control, and suppress psychosocial adaptation abilities, which might, in turn, impair decision-making under risk.
Alcohol affects the frontal lobe, where the majority of our decision-making is processed. It also affects the hippocampus, which is the part of our brain that helps with the process of learning and retaining information. An impaired hippocampus can't obtain and retain new information, which is why a person may not remember the things they said and did while drunk.
Alcohol also affects the hypothalamus, which helps the body maintain homeostasis. Alcohol consumption can make people have a hard time recognising its signals or feel an increased desire to compensate for physical needs.
The consumption of alcohol has a drastic effect on overall brain functioning and can lead to a variety of anatomical concerns. It can alter our mind's perception of coordination and lead us to believe we are more capable of certain movements than we are. This can have a significant impact on our ability to drive safely and appropriately.
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Withdrawal symptoms
Alcohol withdrawal symptoms can range from mild to severe and can sometimes be life-threatening. Severe symptoms include hallucinations, seizures, and delirium tremens (DTs). DTs is a severe form of alcohol withdrawal that can be fatal and typically occurs in people with alcohol dependence. It is characterised by changes in brain activity, which can result in a range of serious symptoms.
Healthcare providers diagnose alcohol withdrawal syndrome based on a physical exam, the patient's symptoms, and their alcohol use history. They may also recommend blood tests and an EKG (electrocardiogram) to check for overall health and assess the risk of health complications. Treatment for alcohol withdrawal varies based on the severity of symptoms and typically includes short-term medications to relieve mild to moderate withdrawal.
To manage withdrawal symptoms at home, it is important to prepare by talking to a doctor or drug treatment specialist about what to expect and whether any medications are appropriate. It is also crucial to have a support system in place, such as a supportive family member or friend, or a support group like Alcoholics Anonymous. Self-care practices like eating healthy foods, exercising, and getting enough sleep can help reduce some withdrawal symptoms. Additionally, managing stress can help reduce symptoms and curb alcohol cravings.
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Negative impact on relationships
Alcohol use disorder (AUD) can have a detrimental impact on relationships, causing lost friendships, estranged marriages, and family conflict. This impact is felt by both the alcoholic and their loved ones. High-functioning alcoholics may be able to maintain stable relationships and excel in their careers, but their addiction can still have negative consequences for their loved ones.
Intimacy and Emotional Availability
High-functioning alcoholics may struggle with intimacy and emotional availability, affecting their ability to connect with their partners and loved ones. They may become emotionally distant or abusive, exhibiting controlling behaviour, threats, and insults. This can lead to feelings of frustration, anger, and anxiety for their partners.
Trust and Transparency
Alcoholics often become secretive and lie to their partners or family members about their drinking habits. They may devise elaborate excuses, disappear for unexplained periods, and neglect responsibilities. This lack of transparency can lead to trust issues and significantly impact the relationship.
Financial Stability
Excessive drinking can result in financial instability, with alcoholics prioritising spending money on alcohol over financial responsibilities. This can cause economic hardship for the family, leading to increased stress and potential conflict.
Impact on Children
Children are particularly vulnerable to the negative effects of a family member's alcohol use. They may experience emotional and behavioural difficulties, such as anxiety, depression, and aggression. They may also become codependent on the drinking behaviours of a family member, which can impact their mental health and well-being.
Codependency
Relationships with high-functioning alcoholics can become codependent, where the non-alcoholic partner prioritises the needs of the alcoholic over their own. This can lead to low self-esteem, depression, and other mental health issues.
While it may seem challenging to confront a high-functioning alcoholic about their addiction, it is crucial for their loved ones to express concern and encourage them to seek professional help. Support groups and interventions can provide a safe environment for both the alcoholic and their loved ones to address the negative impact of alcohol on their relationships.
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Frequently asked questions
A functioning alcoholic is someone who struggles with an alcohol use disorder (AUD) but can maintain the appearance that they are in control of their drinking. They can perform well at work, socialise without drawing attention to their alcohol consumption, and have a good personal life.
Despite the facade of normalcy, functioning alcoholism can have severe consequences over time, impacting physical health, mental well-being, and relationships. It can lead to liver disease, pancreatitis, some forms of cancer, brain damage, serious memory loss, and high blood pressure. It can also cause severe psychological and emotional damage to the alcoholic and their loved ones.
Recognising a functioning alcoholic can be difficult as they rarely show any external signs of addiction. However, some warning signs include drinking alone, drinking in the morning, using alcohol for confidence, and experiencing withdrawal symptoms when they stop drinking. They may also become irritable and restless when unable to drink.
If you or someone you know is a functioning alcoholic, it is important to seek professional help. Speak to a doctor or another medical professional to discuss whether drinking habits are problematic. Early intervention can help prevent further progression of the disease and the development of alcohol-related physical or mental health complications. There are also many resources available, such as 24-hour hotlines, detox centres, and rehab facilities.
