What Is A High-Functioning Alcoholic?

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High Functioning Alcoholic


Beyond drinking socially with friends, or even the rare night out of binge drinking, is the serious and potentially devastating problem of alcoholism. While media portrayals and broader culture have historically created a picture of what the “typical alcoholic” looks or acts like, it is not always easy to identify or dismiss problem drinking within yourself or a loved one.

Nearly 20 percent of those with an alcohol use disorder may be categorized as functional or high-functioning. This means that despite their heavy drinking, they’re able to function at least moderately well in many or all aspects of their work and personal lives. However, this ability to hold a job or perform well in school does not mean that a person is not struggling with an alcohol use disorder.

Understanding High-Functioning Alcoholism

High-functioning alcoholics are individuals who drink an excessive amount of alcohol but are still able to excel or adequately function in their professional and personal lives.

Unlike alcoholics who are unable to keep a job, attend school, or maintain close relationships with friends and loved ones, a high-functioning alcoholic may not appear to be struggling in the most obvious ways.

The National Institutes of Health reports that approximately 19.5 percent of alcoholics in the United States may be categorized as “functional”. However, the limitations that may be involved in identifying the true prevalence of alcohol addiction in research can also mean that this number, as well as general estimates of nationwide alcohol abuse, are lower than actual prevalence.

Alcoholics that are considered highly functional may hide the true extent of their drinking from others and argue that their drinking is under control. They may also not be aware of the costs they are experiencing due to their drinking, as well as how their drinking may be affecting those around them.

High-Functioning Alcoholic_19.5 percent are functional

Functional or not, problem drinking is never harmless. A person may appear to be doing well on the surface, but eventually the consequences of their alcoholism will become more visible, more debilitating, and more difficult to brush off.

High-functioning alcoholics still face the risk of health and medical problems that can result from alcohol abuse. It can take months, or even years, for the most severe consequences to become more evident and compromise the person’s functionality, but no form of alcohol abuse is sustainable or free from consequence.

It is important to try and identify signs of alcoholism as soon as possible to help the person receive the care they need.

What Are The Signs Of High-Functioning Alcoholism?

It may be more difficult to spot indications of high-functioning alcoholism, as a person may seem to be functioning moderately well in most or all aspects of their life. However, this surface-level veil of doing well overall does not negate the distress a functional alcoholic may be experiencing day-to-day.

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Many people who fit within the “functional” subtype of alcoholism can be in denial about having a problem. They may also attempt to hide or downplay their drinking in front of family and friends.

While it may be trickier to spot signs of high-functioning alcoholism, some signs that have been identified by researchers and other professionals include:

  • morning time/day-drinking
  • drinking alone
  • making jokes about how much they drink
  • neglecting or losing friendships/relationships
  • memory lapses after or while drinking
  • drinking to relax or feel more comfortable in social situations
  • asking family or friends to cover for them under circumstances where drinking has affected their work/school

High-Functioning Alcoholic And Depression

In addition, a functional alcoholic may also have comorbid issues, such as mental illness. Approximately 25 percent of functional alcoholics also struggle with depression. Someone struggling with functioning alcoholism may also experience moderate to intense anxiety, frequent mood swings, thoughts of suicide, or exhibit disordered eating patterns. 

The Damage They Do

Those deemed to be “high-functioning” often end up destroying their personal relationships because of their denial. They simply won’t seek the help they need, which often alienates people worried about them. It also gives them carte blanche to behave poorly towards friends and family members, further increasing their alienation.

Work and legal problems are also common with those considering themselves to be “high-functioning.” That’s because they often end up going to work and driving while drunk. Once they cross this threshold, they truly run the risk of transitioning from “high-functioning” to collapsing into the very cliche they had mocked.

And that’s just the damage done to their personal and emotional lives: “high-functioning” alcohol users often suffer from severe health problems, which include:

  • Weight gain
  • Bloating
  • Quicker aging
  • Increased risk of heart problems
  • Nervous system damage
  • Liver disease
  • Poor immune system function
  • Anxiety
  • Nausea
  • Vomiting
  • Increased risk of some forms of cancer
  • Confusion
  • Delusions
  • Seizures

How To Confront A High-Functioning Alcoholic

Confronting someone you care about with concerns about their drinking can be a difficult thing to do. It can be distressing to admit to yourself that a friend or loved one is abusing alcohol.

When preparing yourself to confront someone who appears to be functional, you may feel more doubt about the presence or legitimacy of the problem. You may go through a back-and-forth period, debating whether their drinking is an issue that is worth of confrontation.

You may wish to approach this person on your own, or stage an intervention with other family and friends present. If the person has been unwilling to seek help in previous confrontations, then it may be the time to stage an intervention with several concerned parties present.

Intervention participants may include close friends, close family members, spouses, children, as well as a professional therapist or counselor to help guide the process. However, it is up to you and any other concerned parties to decide which approach you believe may be most effective as a way to get through to your loved one.

Getting Treatment For A High-Functioning Alcoholic

There are a number of treatment options available to help you or a loved one receive help for alcohol abuse. Seeking treatment may seem like an intimidating process, and the deep denial that is often harbored by functional alcoholics can often create additional obstacles.

Treatment for high-functioning alcoholism can be individualized to meet the needs of the person seeking help, and may be available on an outpatient basis, or within a residential or inpatient facility.

Factors that may be considered when determining what kind of treatment a person needs may include how long the person has been abusing alcohol, if they have comorbid illnesses or addictions, and if they have received previous help for their drinking.

To determine what level of care or course of treatment would be most appropriate to best meet the needs of someone you know who struggles with alcohol addiction, contact one of our treatment specialists today.

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