When you think of someone with alcohol use disorder (AUD), do you think of someone who is obviously intoxicated, who can’t hold down a job or maintain relationships, whose life is a mess? While that may be true for some people with AUD, high-functioning alcoholics look fine from the outside, seeming to have it all together. But no matter what form it takes, AUD can negatively impact health, career, and relationships. That’s why knowing the signs and symptoms of a high-functioning alcoholic is the first step towards getting you or your loved one the help necessary to stop drinking.
Is Alcohol a Drug?
Yes, the alcohol found in beer, wine, and liquor is a drug. Alcohol mainly effects three different neurotransmitters in the brain. It causes the levels of dopamine, a neurotransmitter associated with feelings of pleasure, to rise in the brain. It enhances the calming effect of gamma-aminobutyric acid (GABA) on the brain. And it suppresses the effect of glutamate, a neurotransmitter that increases brain activity, resulting in slowed speech, responses, and movements. When consumed in high concentrations, alcohol can cause unconsciousness, coma, and even death. Over time, alcohol consumption changes the way the brain functions and leads to dependence.
What Is Considered Alcoholism?
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines alcoholism, also referred to as alcohol use disorder, as “a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”
That gives us a definition, but what does it actually look like? The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) has identified 11 symptoms that characterize alcohol use disorder. People with mild AUD have two or three of these symptoms. Moderate AUD is defined as the presence of four to five symptoms, and the presence six or more symptoms indicate severe AUD.
What Is High-Functioning Alcoholism?
“High-functioning alcoholic” and “functional alcoholic” aren’t medical terms but shorthand ways to describe a person who meets the criteria for AUD but appears to be functioning well in life. They can hold down a job, meet social and family obligations, and appear to be in good health. They haven’t suffered any visible consequences of their drinking such as a DUI or other alcohol-related legal troubles. Because they haven’t suffered any serious negative ramifications of drinking, they may not recognize their own problem, or they may be in denial about their disease. In addition, they or their loved ones may have a stereotypical perception of what a person with AUD is like: out of control, poor hygiene, can’t keep a job, ostracized by family and friends. Because they don’t have any of those issues, high-functioning alcoholics can justify their drinking. All of these issues make it very difficult to diagnose AUD in high-functioning individuals.
What Causes Alcohol Use Disorder?
Alcohol use disorder can’t be traced to a single cause. Instead, scientists think that AUD results from a confluence of factors, including genetics, a family history of AUD, your environment, and your mental health.
Signs of Alcoholism
If you’re concerned about your own drinking or the drinking of a loved one, it’s important to know the signs of alcohol addiction. They include:
- Drinking alone
- Taking measures to hide drinking
- Being unable to stop after one drink
- Being unable to control the amount of alcohol you drink
- Wanting to stop drinking but can’t
- Blacking out
- Memory loss
- Drinking is part of a routine such as after work or during meals
- Cravings and urges to drink
- Needing to drink more and more to get the same effect
- Hiding alcohol in strange places
- Losing interest in other activities
- Alcohol is creating problems at work, with money, in relationships, or with the legal system
- Experiencing withdrawal symptoms when drinking stops
High Functioning Alcoholism Hides in Plain Sight
Drinking is not stigmatized in the same way many other drugs are. Our society even normalizes alcohol. It’s present at social and business functions. Alcohol is glamorized in pop culture; you could create an entire playlist of songs about drinking. Drinking to relieve stress and pressure is a widely accepted practice. So, it’s easy for a high-functioning alcoholic to blend in as just part of the party.
Signs of High Functioning Alcohol Use Disorder
High-functioning alcoholics may show some of the typical signs of AUD, but there are also other signs to look for:
- Heavy drinking – For women, more than three drinks per day or seven drinks per week; for men, more than four drinks per day or 14 drinks per week
- Denial – They appear functional, denying that there’s a problem, both to loved ones and to themselves
- Defensiveness – Becoming angry or upset when confronted about drinking habits
- High tolerance – Needing to drink more and more alcohol to feel its effects
- Drinking a lot without appearing drunk – People with AUD build up a tolerance to alcohol and can consume large quantities without seeming intoxicated
- Joking about alcohol use disorder – Using humor or jokes to deflect criticism about their drinking
Long-Term Consequences of High Functioning Alcoholism
Because high-functioning alcoholics go longer without being diagnosed or treated, they’re at increased risk for long-term consequences of alcohol use disorder. Drinking too much will, over time, have damaging effects on physical health, mental health, work life, and personal relationships.
While many are familiar with the liver damage caused by alcohol, the reality is that alcohol affects your entire body. The adverse health effects of alcohol include:
- Increased risk of liver, breast, colorectal, esophageal, head and neck cancers
- Increased risk of stroke
- Liver disease
- Pancreatitis
- Respiratory issues
- Alcoholic neuropathy causing numbness in limbs and burning sensation in the feet
- Increased risk of heart disease and heart attack
- Gout
- Erectile dysfunction
- Gastrointestinal inflammation and bleeding
- Weakened immune system
Research has confirmed a strong connection between alcohol use and mental health disorders. Although many people drink alcohol to ease the symptoms of depression and anxiety, alcohol actually exacerbates the symptoms of several mental health conditions, including anxiety, depression, bipolar disorder, and post-traumatic stress disorder. Alcohol use disorder can also create negative emotions such as guilt, embarrassment, and shame. People may then drink more to mask these feelings, creating a vicious cycle.
AUD is damaging to families in many ways. Drinking too much can lead to loss of intimacy and trust in personal relationships. Research shows that AUD leads to higher levels of intimate partner violence, marital dysfunction, and divorce. Children who have at least one parent with AUD are at increased risk of developing AUD themselves.
Help for High-Functioning Alcoholics at The Guest House
At The Guest House, we recognize that AUD is often a coping mechanism for unaddressed trauma. Our compassionate, experienced clinical team uses medical, nutritional, holistic, and evidence-based therapies to help individuals with AUD heal physically, mentally, and spiritually. Our facility is a sanctuary where high-functioning people with AUD process the underlying traumas that drive addictive behavior and learn healthy habits that promote long-term recovery.
Alcohol Withdrawal Symptoms
If you’ve developed a dependence on alcohol, you’ll experience alcohol withdrawal symptoms when you reduce the amount you drink or stop drinking altogether. Withdrawal symptoms typically begin within eight hours of your last drink and include:
- Headache
- Tiredness
- Irritability
- Sweating
- Nausea, vomiting, and loss of appetite
- Difficulty sleeping
- Anxiety
- Depression
- Irregular heartbeat
Heavy drinkers and long-time drinkers who suddenly stop drinking can experience a severe form of alcohol withdrawal called delirium tremens, sometimes referred to as DTs. Delirium tremens can be very dangerous, even fatal, if not properly treated. Symptoms of delirium tremens include:
- Tremors (aka “the shakes”), most commonly in your hands
- Seizures
- Inability to focus or pay attention
- Sudden onset of delirium: disorientation, agitation, hallucinations and confusion
- Agitation and anxiety
- Symptoms of psychosis
- Abnormally high body temperature
- Lack of awareness of your surroundings
Delirium tremens usually begin one to three days after you stop drinking and typically peak within four to five days of your last drink.
Benefits of Quitting Alcohol
Reducing the amount of alcohol you drink or quitting drinking altogether has many benefits for your health, safety, relationships, and well-being. Drinking less reduces your risk of the physical and mental health disorders associated with alcohol including cancer, dementia, liver disease, depression, and anxiety. It also lessens your risk of driving under the influence, one of the leading causes of fatal car crashes. The benefits of quitting alcohol include improved personal relationships, performance at work and school, and physical energy levels. Drinking less or quitting drinking can even help you save money and lose weight.
How to Approach High-Functioning Alcoholic About Treatment
If you’re worried that someone you love is drinking too much, it can be hard to know what to say to them. The most important thing to keep in mind about approaching a high-functioning alcoholic is to do it with compassion and a lack of judgement.
The Substance Abuse and Mental Health Services Administration offers the following tips for talking to a loved one suffering from addiction:
- Choose a time and place when you can talk privately without interruption.
- Be direct about your concerns.
- Ask about their feelings and actively listen.
- Offer help. Let them know that AUD is a treatable disease and treatment is available.
- Have patience. Change takes time.
If you need help talking to your loved one about their drinking, lean on us. Support is just a phone call away. Reach out today: 855-741-2536.