Although the term functioning alcoholic may still be used in some cases, it is important to note that it, along with other words such as alcoholic or alcoholism, has been primarily replaced by the term alcohol use disorder as established by the Diagnostic and Statistical Manual of Mental Disorders. 1
The terms functioning alcoholic or functional alcoholic were, at one time, used to describe someone who struggles with alcohol use disorder while still being able to maintain their family life, friendships, employment, and other daily obligations.
An individual who is a functioning alcoholic has an alcohol use disorder. However, they can generally carry out their daily responsibilities without alcohol hindering success. Someone with functioning alcoholism is typically able to hide their problems with alcohol and, to an outsider, appear to have their drinking well managed. These individuals are sometimes referred to as high-functioning alcoholics.
Conversely, one who has a problematic relationship with alcohol but might not be considered a high functioning alcoholic might be incapable of carrying out their day-to-day obligations because the urge to seek and use alcohol is too overpowering to manage. Additionally, an alcoholic's problematic relationship with alcohol may be visible to friends and loved ones. In some instances, these individuals might be referred to as low-functioning alcoholics.
Because functioning alcoholics often believe they have their drinking “under control,” they may recognize that they have a problem or deny that there is a problem at all. Often, a friend, loved one, or spouse notices the first signs of functioning alcoholic behavior. Common signs of a functioning alcoholic may include a combination of behavioral and physical symptoms. 2
Typical behavioral functioning alcoholic symptoms may include hiding or lying about drinking, lack of interest in hobbies or activities other than drinking, giving up goals or dreams, drinking more than two drinks per day, conflicts with friends or loved ones because of drinking, and new or worsening problems at work or school.
Physical symptoms of a functioning alcoholic may consist of losing control while drinking, experiencing blackouts, and new or worsening medical problems because of drinking, especially liver and stomach issues. In some cases, your loved one with functioning alcoholism may experience withdrawal symptoms if they try to reduce how much they drink or quit drinking entirely.
Suppose your loved one, friend, or partner struggles with the behavioral or physical functioning alcoholic signs above or other common indications of an alcohol use disorder. In that case, it may be a red flag that they need help to put a harmful relationship with alcohol from the past.
A high-functioning alcoholic will likely be able to hide their struggles with alcohol for some time. However, they still experience the physical, social, and emotional consequences of problematic drinking. Many of these risk or high functioning alcoholic signs are like those of individuals diagnosed with alcohol use disorder. For example, new or worsening legal and financial problems, loss of employment, relationship problems, and poor academic or job performance.
A functional alcoholic will also experience various physical and mental health problems related to drinking. Common examples consist of elevated blood pressure, irregular heartbeat, decreased immunity, cancers (head, neck, liver, colon, breast, and esophagus), pancreatitis, liver diseases (fatty liver and cirrhosis), cardiomyopathy (disease of the heart muscle) and stroke. 3
A functional alcoholic may also struggle with various mental health challenges. In some cases, this is due to using alcohol to self-medicate an undiagnosed mental health condition. In others, mental health symptoms may evolve out of excessive drinking or when trying to quit drinking. 4
When someone has a mental health condition and a simultaneous alcohol use disorder, it is called a co-occurring disorder. Alcohol use disorders are often linked to mental health conditions such as anxiety, depression, and bipolar disorder. 5
If your partner or spouse is a functioning alcoholic, it can be challenging to know how to help. Wanting to see your loved one achieve lasting sobriety is a normal and healthy wish. However, the desire to support them can be quickly overshadowed by not knowing how to help your partner see something is wrong.
It is important to remember that the journey to seeking treatment is unique to each person. Some may take longer than others to acknowledge an unhealthy relationship with alcohol and be ready to get treatment. But there are a few things you can do to assist your loved one.
Below are a few quick tips for supporting a functioning alcoholic partner:
Treatment for high functioning alcoholism follows the same pattern as treatment for a diagnosed alcohol use disorder. The best treatment programs often include detox followed by therapy, medications, and self-help (peer support) groups.
The first step in an alcohol addiction treatment program is generally detox. It is crucial to allow the body to rid itself of the influence of alcohol before attempting to engage in a therapeutic program. While still under the influence of alcohol or struggling with cravings and withdrawal symptoms. After detox is complete, it is possible to actively engage in therapy to overcome alcohol addiction.
Therapy for alcohol use disorders is generally offered in individual and group settings. The most popular and most effective therapy model used to address alcohol addiction is cognitive-behavioral therapy or CBT. CBT helps you learn more about the harmful thought patterns that led you to misuse alcohol. It also teaches new, healthy thought patterns that allow you to alter unhealthy drinking behaviors.
Although not suitable for all cases, medications may help alleviate some of the more intense symptoms of alcohol withdrawal, including cravings and other physical symptoms. Using medications as part of a medically supported detox and treatment program can, for some, lead to safer, more effective withdrawal while reducing the chances of relapse. 6
Peer support groups are free groups open to those at any stage of their recovery from an alcohol use disorder. The most well-known of these groups include AA (Alcoholics Anonymous) and SMART Recovery groups. Peer groups are frequently incorporated into a comprehensive aftercare plan; however, they are also an effective primary treatment component.
If your loved one is a functioning alcoholic, they are likely able to fulfill their daily responsibilities regardless of their relationship with alcohol. From the outside, nothing appears wrong. However, they will also struggle with the harmful physical and emotional symptoms of alcohol addiction. Seeking professional treatment is the best way to overcome functional alcoholism. Contact us today to learn more about getting help at Genesis Recovery.