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What is a functioning alcoholic?

Drinking high levels of alcohol on a long-term basis can have harmful effects on the brain.

Functioning alcoholics may ask: ‘how can I have a drink problem when there are no consequences in my life?’

In reality, there are always negative consequences of alcoholic drinking, although these may sometimes go undetected for as long as the drinking itself.

Functioning alcoholics are not fully functioning people. They are men and women with a significant drink problem who manage to keep doing most of the essential things in life that normal people do – and even follow a daily schedule – but only just.

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Being a functioning alcoholic is like driving a car with the handbrake on – you can do it for a while, but it requires huge energy, and everywhere you go, there is the faint smell of burning rubber. People may suspect a problem, and they are usually right.

Characteristics of the functioning alcoholic

Drinking and the likely hangover that follows rarely cause such people to miss their work or other commitments, but the effort needed to keep them on track takes a grim toll. This manifests in a constant state of ‘hangxiety’, combining today’s nausea, guilt and depression with an acute fear of tomorrow’s inevitable rough morning.

They are usually able to manage the key areas of life – work, socialising, relationships and finances but the warning signs are there. Some manage to keep going for years but it is not a good or happy way of life and sooner or later, a crisis will happen.

Functioning alcoholics may appear relatively healthy, both physically and mentally. But, below the surface, they will almost inevitably be experiencing some sort of withdrawal symptoms such as restlessness, tremors, obsessive thoughts of drinking or just plain cravings for more alcohol. 

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Who is most at risk?

Functional alcoholics are often thought normal by colleagues or loved ones because they do not conform to the general perception of an alcoholic as badly behaved, unreliable and unemployable. Instead, they are often middle-aged family types with steady jobs and social standing. This may lead to their drinking appearing unproblematic for a long time.

Risk factors

A person’s dependence on alcohol may have started in a number of ways of which the following are the most common: 

  •       A lifestyle where regular drinking is the norm
  •       Experiencing constant stress at work or elsewhere
  •       Peer pressure to drink or party on a regular basis
  •       Family history of addiction or mental health problems
  •       Low self-esteem or sociophobia

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Warning signs

Although their lives may not appear to be affected in the same way as the typical alcoholic, they may still find it hard to keep their condition completely undetected. There are certain warning signs to watch for:

  •       Drinking patterns such as large amounts, alone and at odd times of day
  •       Justifying or minimising drinking behaviour
  •       Needing alcohol for all forms of socialising
  •       Mental confusion or memory lapses after drinking
  •       Irritability or aggression when drinking
  •       Secretive drinking or hiding alcohol
  •       Restlessness when unable to drink

High-risk behaviours

People can successfully hide their drinking problem for years, but they somehow must meet the increasing need for alcohol their body craves, and this forces them into high-risk behaviours such as drink driving, drinking while in charge of small children, operating dangerous machinery or poor decision-making that adversely affects the lives of others.

In some ways, this can be a more dangerous situation than overt alcoholism. 

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Denial

Functioning alcoholics are a danger to themselves and to others with possibly dire consequences, and the sooner they can seek treatment, the better. However, when a person is apparently performing well at work, at home and elsewhere they may continue to delude themselves into thinking that everything is ok.

This is especially true for those able to buy themselves out of trouble and those who are not likely to be confronted about their behaviour.

They may ask: ‘how can I have a drinking problem when there are no consequences in my life?’

In reality, there are always negative consequences of alcoholic drinking although these may sometimes go undetected for as long as the drinking itself. More on Denial.

If you suspect there is a problem

Perhaps the fact that you even suspect a drinking problem is significant. Here are some questions you could ask yourself. If the answer is ‘yes’ to two or more, we suggest that you seek professional advice:

  •       Do you ever drink more than you intended?
  •       Have you tried to cut down on drinking and failed?
  •       Have you lost or damaged relationships through drinking?
  •       Have you ever been confronted about your drinking?
  •       Has drinking caused you serious trouble (eg drink driving)?
  •       Do you drink more than you used to?
  •       Do you ever experience tremors, sweats or restlessness after drinking?
  •       Have you ever hidden your drinking?
  •       Have you continued to drink despite health or emotional problems?

 Try to answer these questions honestly. When dealing with addiction, the pain of doing nothing will always be worse in the end than the pain of taking action.

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 Tolerance

An alcoholic who manages to function in society but is nevertheless consuming large amounts of alcohol may not exhibit outward symptoms of intoxication but will very likely be damaging themselves. Their tolerance to the drug will have built up to the extent that they risk seriously damaging internal organs such as the liver, spleen and kidneys. They will also be in danger of cognitive impairment, especially memory loss. 

Living with a functioning alcoholic

Daily life can be stressful when your partner is unreliable and their mood is unpredictable. When your partner appears to be functioning normally while actually struggling with addiction, it may be hard for you to find support because to the outside world there seems to be nothing wrong.

This may even make you doubt yourself and lead to co-dependence where you will go to great lengths to preserve the illusion of normality.

Soon you become unable to be happy unless your partner is happy, so you start shielding them from stress, making excuses or covering up for them. They say that ‘secrets make us sick’ and if your partner is living a lie which you are enabling, then you are probably both sick to some extent.

If you suspect your loved one is a functioning alcoholic

Addiction of any kind often puts people into denial and makes them defensive, unresponsive, irritable and sometimes aggressive. However, it is important to address such a problem sooner rather than later. Doing nothing or worse, enabling the behaviour through covering up or ignoring it, will not help. Here are some points to remember when you feel the need to have a conversation on the matter:

  •       Be sure to talk when your partner is sober and able to think clearly.
  •       Don’t make it personal – criticism of their behaviour is not as helpful as expressing the effect on you and the rest of the family.
  •       Try to be understanding and compassionate. Hate the disease, not the person.
  •       Do not accept excuses, justifications or promises to change.
  •       Offer practical help – the person may be unaware of their problem or in denial. Make it clear that help is available.
  •       Avoid confrontation. Addiction is cunning, baffling and powerful and must be addressed with care and directness rather than acrimony and dispute.

Treatment options for functioning alcoholics

There are plenty of sources of treatment for functioning alcoholics. Because of their perceived ability to cope, the difficulty may lie not in finding help but in persuading the person to recognise the need. However, once the initial denial has been addressed, the first step would be to meet a healthcare professional so that the extent of the problem can be assessed. 

Typically, people with a history of high functioning while struggling with a drinking problem respond well to residential treatment. Here, they can enjoy time away from their usual lifestyle and focus on an intensive programme of education, self-discovery and personal change with full medical and therapeutic support. At Castle Craig Hospital we are available 24/7 to discuss and advise on treatment options.

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