Am I a High Functioning Alcoholic?
The stereotypical image of an alcoholic is often someone who is jobless and/or homeless, someone who appears outwardly disheveled and unkempt, and someone who may have lost the people and things in their life that matter. Unfortunately, this is not always the reality. These stereotypes are usually the result of a much longer process and might be referred to as a person’s “rock bottom.”
Instead, some people may be labeled a “high-functioning alcoholic,” someone who still maintains a job, keeps relationships, and has experienced only moderate or even no consequences as a result of their alcohol use. In general, these individuals are able to keep up with many of their responsibilities and appear to outwardly “have it all together.”
According to the American Bar Association, as many as one in five lawyers is a problem drinker. Similar rates plague physicians with nearly 10-15% of all doctors in the United States reporting alcohol abuse. The very strengths that professionals have (problem-solving, caretaking, perfectionism) may end up being hurdles in recovery.
It may be particularly challenging to recognize drinking issues with high functioning alcoholics since they do not fit the stereotypical picture of the alcoholic. Often, their alcoholism progression cannot be measured by severity of consequences. Further, their success in other areas of their life might lead people to overlook their drinking habits resulting in a delay in seeking help and getting professional treatment. The high-functioning alcoholic may also be in denial since they may compare themselves to the stereotypical alcoholic and rationalize that “I’m not that bad off” or “I’m not like them.”
According to a 2007 report conducted by the National Institutes of Health (NIH), nearly 20% of all alcoholics were well-educated, had steady employment and had families. On the outside, they appear to have a normal, successful life. However when it comes to their drinking, here are some red flags and common signs of a high-functioning alcoholic:
Drinking as a coping tool
For some people, drinking can have a calming effect during high stress times. Alcohol is a sedative and a depressant that impacts the central nervous system, thus it can have a dampening effect on stress levels. However if one is looking forward to a drink to relieve their stress on a regular basis and using it as their primary coping mechanism, it can be a red flag. In the long term, heavy alcohol use can alter the brain’s chemistry in such a way that a person is more anxious when they are not drinking, thus fueling the need to drink more and creating a cyclical effect where stress and alcohol feed off of eachother.
Additionally, when someone is accustomed to drinking away stress, they may feel more anxious when they cannot have alcohol and may even build tolerance so that they need more alcohol to experience the same calming effect that they once enjoyed after a single drink. This can also lead to alcohol cravings, difficulty concentrating when not drinking and alcohol withdrawal.
Many high-functioning alcoholics may believe that their drinking actually helps their work performance because it takes away some of their stress so that they are able to concentrate better. This may lead to the next sign of a high-functioning alcoholic, drinking during the day or at work.
Drinking during the day or at work
When someone has grown accustomed to using alcohol on a regular basis, they may also have developed a dependence on alcohol. As a result, when the person is not drinking, they experience withdrawal symptoms that may mimic that of stress and anxiety such as nervousness, faster heart rate, shakiness, irritability, headache, nausea, sweating. Once a person has developed these symptoms, the only way to prevent these symptoms throughout the day is to drink more alcohol.
This day drinking may start as a drink at brunch or during a work lunch, however this likely transitions to more red flag behaviors, such as hiding alcohol at work, sneaking drinks during work breaks, or having a morning drink to start their day. For the high-functioning alcoholic, they may believe that their drinking actually helps them perform their job better or they may only drink in certain high-stress situations. However, if this behavior becomes habitual, it is unlikely that a person will be able to prevent cravings or future withdrawal symptoms.
While the high-functioning alcoholic may day-drink with peers and colleagues at social gatherings, it is possible that they may drink more alone, hide the amount they drink or feel compelled to drink before attending social events.
Resolutions to stop
The drinking habits of a high-functioning alcoholic may or may not draw attention from colleagues, friends and family. If confronted about the amount they drink, the person may make jokes to downplay the concerns, they may get defensive about the accusations, and they may minimize the concerns by highlighting how well they are performing at their job.
Unfortunately, for the high functioning alcoholic, a person likely has increased the amount they drink and how frequently they drink to warrant concern from their peers. Moderate drinking for women is defined as drinking one drink a day and two drinks a day for men. A high functioning alcoholic likely drinks more than this once they have developed a tolerance. They may try to resolve to drink less, but they are likely unable to control this amount for a sustained period of time. They may also spend a significant amount of time thinking or obsessing over when they will be able to drink.
The NIH’s National Institute of Alcohol Abuse and Alcoholism (NIAAA), defines binge drinking as a pattern of drinking alcohol that equates to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking 5 or more alcoholic drinks for males or 4 or more alcoholic drinks for females on the same occasion on at least 1 day in the past month.
NIAAA defines heavy alcohol use as more than 4 drinks on any day for men or more than 3 drinks for women. SAMHSA defines heavy alcohol use as binge drinking on 5 or more days in the past month.
The high functioning alcoholic is unlikely to admit that they have a drinking problem because it is possible they do not see it as a problem. Since they may have experienced fewer consequences than the stereotypical alcoholic, they may honestly believe that their drinking does not impact their lives in a negative way thus they do not need to change their behaviors. This potentially makes it harder for a highly functional alcoholic to seek help and get treatment.
Unfortunately, if a highly functional alcoholic has experienced any of the signs aforementioned, but continues to drink long-term, it is likely that their mental and physical health will continue to deteriorate, even if their outward appearance remains the same. They may begin to experience problems socially, professionally and financially and begin experiencing some of the physiological effects of long term alcohol abuse.
High functioning alcoholics may experience depression, anxiety, malnutrition, insomnia, violent or aggressive behavior or alcohol poisoning. They may face legal troubles such as DUIs or lose their jobs due to poor performance or drinking at work.
Alcohol Rehab in Florida
If you or someone you know identifies with the aforementioned signs of a high-functioning alcoholic, it may be helpful to seek a professional opinion. At Genesis House, addiction treatment specialists are able to work with you or your loved one to assess your situation and determine an individualized treatment plan that will suit your needs. A professional will be able to take a thorough substance use history and determine if alcohol treatment is recommended and the best therapeutic course of action is warranted.