Home Addiction Alcohol Addiction What Is a High-Functioning Alcoholic? Know the Signs
Last Updated Dec 2, 2021
0 sources cited
A high-functioning alcoholic is a person who holds onto their job and their family while being psychologically dependent on alcohol. Sometimes the pressure and success of the outwardly perfect appearance of their lives drives them to drink more, pushing their body and their relationships to the brink.
What Is High-Functioning Alcoholism?
A high functioning alcoholic (also simply known as a functioning alcoholic) is a person who is able to maintain a personal and professional (or academic) life while still having a psychological dependence on alcohol.
They are distinct from moderate drinkers, who are able to resist the temptation to drink since they have no psychological dependence on alcohol. High-functioning alcoholics are also distinct from the model of the traditional alcoholic, who is unable to maintain a work/school and/or a family life because of their dependence on alcohol.
Signs of a Functional Alcoholic
While functional alcoholics present as though they don’t have a problem with alcohol at all (and can win acclaim for being able to “hold their liquor”), the “alcoholic” part of the equation still comes with all the risks of being an actual alcoholic. They may:
- Drink during the day.
- Become irritable and hostile when they do not have access to alcohol.
- Make up reasons to drink.
- Be unable to drink in moderation.
- Lie about their drinking habits and cover up evidence thereof.
- Be prone to impulsive and risky behavior (like pursuing illicit relationships or engaging in other forms of compulsive behavior like gambling and occasional drug use).
- Angrily reject any suggestion that their consumption of alcohol is out of control, often using their successful ability to have a family and a professional life as proof that there is nothing wrong with their drinking.
Those are the signs to look out for to tell if someone is a functional alcoholic. It may be harder to notice in such a case because a functional alcoholic will become very adept at disguising their drinking.
If alcohol plays an outsized role in their lives, it doesn’t matter how well they are able to hold their family and their professional lives together. They still have a form of alcohol use disorder, and the problem needs to be corrected before something terrible happens to them or their health.
Disguising & Denial
A functional alcoholic can convincingly claim that they are not, in fact, alcoholics because their drinking does not disrupt their home life or their work life. Some go so far as to justify their behavior because of that reason, arguing that they deserve to drink (even to excess) because of their success, or that their personal and professional success entitles them to drink as much as they want, whenever they want. In the same way that the other presentations of alcoholic behavior are often manipulative and coercive, functional alcoholism can disguise itself very effectively under a veneer of respectability.
In some cases, functional alcoholics might not even know that they have this form of alcohol use disorder. They have become so good at maintaining their responsibilities and their drinking habits that it might legitimately never occur to them that they have become bound to their alcohol addiction. Even if they don’t realize the scope and extent of their problem, the fact that alcohol has such a dominant presence in their lives is what qualifies them to be functional alcoholics.
Denial is a significant component of functional alcoholism, and one that makes recognizing its signs so difficult. As the severity of the alcohol abuse deepens, so too does the denial. A functional alcoholic who sees no issue with their alcohol intake will strongly reject the notion that their drinking is problematic at all, making it all the harder to convince them to discontinue the behavior and get help.
The Inescapable Reality of Alcoholism
This is a lose-lose situation since being confronted about the problematic drinking is likely to make a person with functional alcoholism fall back on their habits even more. The danger is that it will take a truly catastrophic turn of events to make them realize the consequences of their behavior.
While the term rock bottom tends to be used very loosely when it comes to alcoholism, even functional alcoholics will ultimately struggle to maintain the facades they’ve carefully constructed to hide their drinking, eventually resulting in anything from a DUI to some other form of an inescapable sign that their behavior fits the criteria for alcohol use disorder.
Even if a person who is a functional alcoholic is able to maintain an outward appearance of having it all together, one of the key dangers of functional alcoholism is that the unchecked alcohol consumption still takes a physical toll. Such dangers include liver damage, heart disease, issues with the brain and nervous system, and even death.
What makes this so dangerous is that a person who is a functional alcoholic will become very good at denying any negative effects of their drinking, all while their body is breaking down because of the excessive alcohol consumption.
How to Help a Functional Alcoholic
Before it gets to that point, there are ways to guide a functional alcoholic to accept the truth.
How can you help someone who is a functional alcoholic? One of the first things to do is to talk to them when they are not drunk. Choosing a moment when they are hungover, or feeling guilty about the way they behaved when they were drunk, gives you an opportunity to expose the veneer that functional alcoholism puts up. This also makes it more likely that the person will agree that their drinking is out of hand, and they will be more amenable to seeking professional help.
A big part of the process is giving them an ultimatum to make them stop their problematic behavior or else they will suffer material consequences, such as termination of employment, eviction, or the end of a relationship. Even if the person displaying the behavior of a functional alcoholic tries to deny that they have issues with their consumption of alcohol, and can point to a functioning home and work life, they have to be convinced that any further drinking is grounds for consequences.
Talking to someone about their functional alcoholism means telling them that even though outward appearances indicate a successful and happy life, your relationship and your feelings are nonetheless being harmed by their behavior. Document experiences like arguments, past (failed) attempts at giving up drinking, or a loss of intimacy or closeness as examples of how the functional alcoholism has negatively impacted your life and their life as well.
Take care not to simply attack your loved one because condemnation or accusations can easily push them toward hostile and defensive behavior. Addiction experts recommend using compassion, appealing to the person’s better self, as a way to motivate them to sincerely want to stop drinking and to seek professional treatment.
But it should always be made clear that if the person does not accept this outreach, or if they secretly renege on whatever assurances they make, the consequences will be swift and complete. Any hint that the line in the sand will be conceded may be exploited by the person’s desire to continue drinking.
You must be clear, firm, and rapid with your ultimatums. One way or another, the person must be convinced to seek help for their functional alcoholism.
Functional Alcoholism Is Still Alcoholism
Even though functional alcoholism may present itself as a form of alcohol use disorder that is “not so bad” because of how the person is able to manage their professional and personal lives, it is still a condition that requires specialized medical treatment.
A person who is a functional alcoholic should not simply discontinue their drinking, as their psychological and physical dependence on alcohol is still strong. Abruptly depriving their body of the substance on which it had come to depend for so long could be extremely damaging and even dangerous to their health.
A person who wants to recover from being a functional alcoholic must check into a treatment and rehabilitation facility, where they will receive the medical care they need to successfully (and safely) wean off the physical need for alcohol. Then, they can receive the counseling and therapy they need to control their psychological desire for more alcohol. With comprehensive care, they can manage functional alcoholism.
High Functioning, But Still Alcoholic. (May 2009). The New York Times.
Understanding Alcohol Use Disorders and Their Treatment. (2012). American Psychological Association.
How to Recognize the Manipulation of a Drug Addict. (October 2018). Psych Central.
Denial in Alcohol Use Disorder. (July 2021). Psych Central.
The Various Ways High Functioning Alcoholics Hit Rock Bottom. (April 2009). Psychology Today.
“I Gave R. An Ultimatum: It’s the Drink or Me.” (July 2013). The Guardian.
The Good — and Bad — Health Effects of Alcohol. (October 2021). Forbes.
Ways to Approach the High-functioning Alcoholic in Your Life. (June 2009). Psychology Today.
How to Have Compassion for an Addict. (October 2016). US News & World Report.
Treatment of Alcohol Use Disorder. (February 2021). JAMA.
Further Reading +
- Alcohol Addiction
- You Just Relapsed – What to Do Next
- Guide to Drug Detox: What to Expect During the Process
Feeling a strong craving or urge to drink alcohol. Failing to fulfill major obligations at work, school or home due to repeated alcohol use. Continuing to drink alcohol even though you know it's causing physical, social, work or relationship problems.
Often someone who is abusing alcohol will also display the following signs and become:
- Easily aggravated.
Similarly, the types of personality disorders, including their combinations, found to be related to alcoholism are very heterogeneous. The most consistent have been: histrionic/dependent, paranoid, dependent/paranoid/ obsessive-compulsive, narcissistic/avoidant, antisocial, borderline, and avoidant/borderline (54).
Not keep up with major responsibilities at home, work, or school. Lose friendships or have relationship problems due to drinking, but you don't quit alcohol. Have legal problems related to drinking, such as a DUI arrest. Need alcohol to relax or feel confident.
One of the physical characteristics of someone who is a heavy drinker is bloodshot eyes. This change in appearance is due to alcohol abuse swelling the tiny blood vessels in the eye, enlarging their appearance and making the eyeball look red.
Dry wrinkled skin
Alcohol causes your body and skin to lose fluid (dehydrate). Dry skin wrinkles more quickly and can look dull and grey. Alcohol's diuretic (water-loss) effect also causes you to lose vitamins and nutrients. For example, vitamin A.
Narcissists are defined by entitlement. Lacking empathy and feeling superior, they give themselves full permission to do whatever the want despite the rules or costs to others. Alcoholics sacred entitlement is drinking. They may lose everything and everyone in their lives before they will give up alcohol.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholism can alter one's personality because of its effects on an individual's brain function especially when there is too much alcohol intake.
Narcissism and alcoholism are different conditions, but they can occur simultaneously and may share some overlapping symptoms. While both conditions can be challenging, certain approaches can help individuals overcome the potential complications of these disorders.
According to the National Institutes of Health (NIH), three mental disorders most commonly comorbid with alcoholism are major depression, bipolar disorder and anxiety disorder.
Narcissism may lead to alcoholism in some patients due to their grandiose view of themselves and denial of a negative outcome occurring. Alcohol abuse can cause people to develop narcissistic personality disorder as they become defensive about their substance use and whether they have an addiction.
- Poor coordination.
- Slurred speech.
- Impaired thinking.
- Memory impairment.
- Wanting to stop drinking but not managing to do so.
- Diverting energy from work, family, and social life in order to drink.
To check your blood for alcohol, your doctor uses a needle to take blood from your arm and measure the amount of alcohol. The other tests you might get for alcohol, like a breath or urine test, don't use blood samples. Each of these tests has the same goal: to check how much alcohol is in your body.
Alcohols bind with other atoms to create secondary alcohols. These secondary alcohols are the three types of alcohol that humans use every day: methanol, isopropanol, and ethanol.
For most men, that's defined as more than 4 drinks a day, or 14 or 15 in a week. For women, heavy drinking is more than 3 drinks in a day, or 7 or 8 per week. Too much alcohol can harm you physically and mentally in lots of ways.
Stage 4: Late Alcoholic
At this stage, drinking becomes everything in your life, even at the expense of your livelihood, your health and your relationships. Attempts to stop drinking can result in tremors or hallucinations, but therapy, detox, and rehab can help you get your life back.
- swelling of your liver, which may lead to discomfort in the upper right side of your abdomen.
- unexplained weight loss.
- loss of appetite.
- nausea and vomiting.
Second stage alcoholism is also known as middle stage alcoholism. At this stage, an alcoholic will start to develop strong cravings for alcohol. These individuals no longer drink for enjoyment. They need to drink to survive.