Alcohol use disorder can impact people in many ways. The body’s dependence on alcohol can be disastrous, causing harm to both physical and mental health.
For most, the disorder is unbearable. It destroys their social life, puts their career in jeopardy, and causes potentially fatal health complications.
However, there are some individuals who are able to seemingly cope fine with the condition, sustaining successful professional and social lives while still being dependent upon regular alcohol consumption . These are known as high-functioning alcoholics.
What is ‘high-functioning’?
‘High-functioning’ means that an individual is able to keep up the appearance of normality throughout their addiction. While drinking excessively, they manage to maintain seemingly prosperous social lives and physical health.
The ability to maintain this image tends to stem from their alcohol consumption pattern, which differs from that of the average alcoholic. For high-functioning individual, their drinking is frequent but moderate. They consume a lot throughout the day, but never enough to get drunk.
As a result, they maintain the appearance of being normal while alcohol is constantly present in their system. Sustaining this is managed by the small doses they take, which the body processes quickly enough to avoid becoming drunk.
What might also happen is that an individual may limit their drinking to the times of day where no one else is around. They may be sober all day and then drink excessively in the night, appearing completely fine to colleagues and friends the following day.
However, it is important to note that this normal image is an illusion. High-functioning alcohol addiction is just as serious as any other, and an individual will still experience the negative effects of dependence.
What are the signs?
Spotting alcohol dependence is incredibly difficult. Those who drink are often good at keeping the extent of their alcohol consumption hidden from others. Therefore, it can be even harder to spot a high-functioning alcoholic.
The nature of high-functioning addiction means that it is hard to notice, but there are signs to look out for. These include:
- Drinking at unusual times, such as in the morning or during breaks at work
- Having large stores of alcohol in the home
- Drinking as a means of rewarding or relaxing throughout the day
- Considering drinking as a normal procedure rather than a recreational activity
- Using humour or comparing themselves to other alcoholics as a means of downplaying their drinking
For high-functioning alcoholics, drinking is a normalised part of life. They consume an excessive amount, but their behaviour constantly looks to downplay the severity of doing so.
In addition to these signs, a high-functioning alcoholic may also show two more: denial and increased tolerance to alcohol.
1. The role of denial
Denying the existence of a problem is very common among those who struggle with alcohol abuse. They often claim that they only drink for fun and that they could stop anytime if they chose. This is thought to be a key component when it comes to high-functioning addiction.
Being dependent on alcohol is a difficult reality to face, and it is common for friends and family to point towards the damage of an individual’s drinking to emphasise the problem.
However, with high-functioning alcoholics, these problems do not appear. Individuals continue to live and work normally, and so no one is there to highlight the existence of an alcohol problem. As a result, they are often in denial.
Without any observable consequences of their excessive drinking, an individual will not see a problem with their behaviour. They will disassociate with the condition of alcoholism – highlighting their social lives and good health as evidence – and see their drinking as normal since it does not seem to do them harm.
Often, it is in later life when the damage becomes apparent. Liver failure, for example, can occur after prolonged alcohol abuse, and so it is only then when an individual is faced with the consequences of their drinking.
2. Increased tolerance
As an individual drinks more and more, their tolerance for alcohol increases. Their body begins getting used to the substance, and so more of it is required to produce the euphoric effects associated with it.
For high-functioning alcoholics, this plays a vital role in their ability to retain their normal image.
As they develop their addiction, an alcoholic’s tolerance towards the substance causes the body to become resistant to its effects. As a result, small doses – such as a single glass – will not cause much of an impact.
A high-functioning alcoholic, therefore, can drink small amounts of alcohol throughout the day without ever appearing drunk to others. Their tolerance is developed enough so that small amounts are quickly metabolised and filtered, allowing an individual to drink frequently without it showing in their behaviour.
An individual might drink in the morning, afternoon, and evening, and still remain sober. Without a proper test, the average person would not be able to detect that they had been drinking
This principle also applies to those who consume large quantities of alcohol during the evening or night. They can drink heavily, but do not appear hungover the next day thanks to their enhanced tolerance.
When an individual develops a physical dependence on alcohol, their body struggles to cope with its absence. It becomes imbalanced, and the body’s natural reaction is adverse. This causes withdrawal symptoms.
Like other alcoholics, high-functioning individuals experience these effects. Their continuous drinking sustains their body’s chemistry so much that it does not know how to respond when alcohol is taken away.
Alcohol withdrawal can be incredibly dangerous. Some of the effects include:
- Increased anxiety
- Mood swings and irritability
- Poor judgement and confusion
- Increased heart rate
- Profuse sweating and shaking
- Fatigue and restlessness
In more serious cases, withdrawal can be fatal. An individual can experience very dangerous seizures or cardiac arrest, both of which can kill.
The discomfort and potential dangers posed by alcohol withdrawal is what prompts high-functioning alcoholics to sustain their alcoholic use.
Treatment and recovery
High-functioning alcoholics cannot maintain their normal image forever. Eventually, the effects of their drinking will manifest and put their lives at serious risk. Treating their addiction, therefore, is ideally done before this point.
An individual concerned about their own or a loved one’s drinking is recommended to contact their GP or an alcoholic organisation to discuss the details of their situation.
With professional help, an individual can undergo safe detox with the assistance of medication and therapy.
Approaching someone who needs help
It can be very difficult to know what to say to a friend or loved one who is showing some of the signs of high-functioning alcoholism. Their denial might cause them to be angry at your approach.
When trying to appeal to them to seek help, it is important to remember some of the following things:
- Be calm, compassionate, and honest with your intentions
- Offer support with the recovery process
- Research and explain what treatment options are available to them
- Explain what signs you have noticed
- Explain the risks of alcoholism
- Remain patient and do not lash out
An individual must remain calm and supportive when approaching a high-functioning alcoholic. Only with patience and understanding will they have a chance of breaking through and convincing their friend or loved one of the severity of the situation.