High-functioning alcoholism is a misnomer. The correct name for it is Alcohol Use Disorder, the same name applied to alcoholism broadly. The term “high-functioning alcoholic” is not medical but rather a cultural descriptor used by laymen and experts to note easily observed behaviors.
Think about what your stereotype of an alcoholic would be. Slurred words, bloodshot eyes, constant handshaking, milling around a liquor store, vomiting, and asleep a good portion of the day.
Bundled together, these amount to severe alcoholism and make it challenging to be on your feet, much less hold down a job or lead a typical life. But what most don’t know is that Alcohol Use Disorder works on a spectrum.
Let’s consider another scenario; a peek into another life. A lawyer gets up in the morning, cleans his face and applies aftershave. He goes to work, talks to two clients, takes a two-hour lunch, and is back in the office after noon for some work. There’s an office party at 9, which he attends, and then he drives back home at 12. This sounds like a perfectly well-adjusted person.
What if he started the day with a drink before arriving at the office? During that two-hour lunch, he had four drinks and napped for an hour. The work he did afterward was sloppy and incomplete.
When he got home, he didn’t spend time with his wife or play with his children; he crashed straight to bed. He got up before the party to have a few drinks, all of which he hid from his family, to have a buzz before arriving. He then drove to the party drunk and went home drunk.
This is our stereotype of a high-functioning alcoholic. Someone who manages their alcoholism while seemingly leading a normal life, hiding or minimizing behaviors on the extreme end of the condition.
But this does not diminish the fact that the condition is still alcoholism and has terrible consequences. In that scenario alone, we described two DUIs, a diminishment of family time, and poor workplace performance, not to mention the health effects of following this routine. Over not that long, these accumulate and become catastrophic for social, mental, work, and inner life.
What Is High-Functioning Alcoholism
The National Institute on Alcohol Abuse and Alcoholism describes heavy drinking as
- More than four drinks on any day or more than 14 drinks per week for men.
- More than three drinks on any day or more than seven drinks per week for women.
This is paired with binge drinking, which involves five or more drinks for males and four or more for females. This combination of heavy and binge drinking amounts to Alcohol Use Disorder (AUD). AUD can be mild, medium, or severe. The pernicious stereotype of the condition is that, despite it affecting anyone, alcoholics are “low class” or “skid row.”
The image of a man holding a brown paper bag and stumbling down the street comes to mind. This harmful myth has prevented many from truly understanding the condition—Betty Ford, Elizabeth Taylor, Robin Williams, Eric Clapton, and Keith Urban are all high-functioning alcoholics.
Studies suggest as much as 50% of alcoholics maybe be high-functioning, with other estimates as high as 75%. With these high numbers, getting away from the stereotype is essential. High-functioning alcoholics have higher than average tolerance for the physiological effects of alcohol.
They may not experience physical alcohol withdrawal symptoms, which are the things that usually compel an alcoholic to drink and avoid. Instead, they are psychologically addicted.
They crave the next drink, feeling it would improve their mood or need it to perform socially. For high-functioning alcoholics, that next drink might just come down to stress management, a reward for getting through a difficult day.
That obsession with the next drinking opportunity manifests as unhealthy drinking behaviors. They always have to finish a bottle, never having just one drink.
When under the effects of alcohol, high-functioning alcoholics tend to exhibit personality changes. This can lead to risky, self-destructive behaviors.
How High-Functioning Alcoholism Is Sustained
The first thing a high-functioning alcoholic does is engage in self-denial. Due to their success and general state of life, they will tell themselves that they do not have a problem.
The stereotypes around drinking are such that their friends and family will believe so too. Instead, their alcoholism will appear as a quirky character trait. They like to get a little drunk, that is all!
Part of maintaining this façade involves the construction of a double life. High-functioning alcoholics will hide their actual consumption from others.
Drinking before events, sneaking in shots, and keeping private bottles are all common behaviors. They might be very good at bifurcating their professional life and drinking time, avoiding visible drunkenness around coworkers, and picking their spots carefully.
This is sustained by the ability to take a hit. Unlike severe alcoholics, high-functioning alcoholics tend not to hit rock bottom. They have the financial resources and social infrastructure to cushion a loss. Finally, if things do get overwhelming, they have the ability to quit for sustained periods.
Effects of Prolonged High-Functioning Alcoholism
High-functioning alcoholic is not synonymous with the high-functioning person. Over time, through repeated brushes with drunkenness, body, mind, and life pays a toll.
One may sustain a professional or academic career while drunk, but performance will not be optimal and dips into substandard during stormy periods. Alcoholism does not supplement career growth; it inhibits it by holding back mental ability under grogginess, tiredness, and inflammation.
While drinking hours may not overlap directly with work hours, they overlap with family time. Drinking may increase irritability, risky sexual behavior, driving under the influence, and other irrationalities that significantly strain a family or marriage.
One cannot run from this forever; eventually, there will be tremendous personal consequences. High-functioning alcoholics spend a lot of nights drunk, and it only takes one bad night to ruin a relationship forever.
Additionally, the effects of long-term alcohol abuse are not lessened just because a high-functioning alcoholic maintains a professional life. These include
- Higher cancer rates of the throat, breast, mouth, liver, and just about every place in the body.
- High blood pressure
- Increased risks of stroke.
- The buildup of uric acid in the joints causing gout.
- Damage to the liver causing cirrhosis.
- Overall inflammation, which harms the brain, the digestive system, and the pancreas.
- Mental health effects, like depression and even long-term nerve damage.
When the bill is due, high-functioning alcoholics cannot discount it. Although it is easy to minimize hard drinking as a choice, it is a condition that can be treated!
If this sounds like you or you know a loved one or family member who suffers from the condition, don’t hesitate to reach out. GateHouse is here to help you begin your journey toward lifelong health and sobriety.
We have a dedicated team of experts and therapists and offer outpatient, partial, and inpatient treatments, among other programs. It all starts with a phone call. Contact us at (855) 448-3588 to speak to someone who can help.
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