The paradox of functioning alcoholism

What does it mean if someone is described as a functioning alcoholic? The term describes a person who is dependent on alcohol but can still manage to fulfil their daily responsibilities. This paradoxical expression is not a formal medical diagnosis, but a way to recognise that people struggling with alcohol addiction, cravings, unsuccessful attempts to quit, and obsessive thoughts about drinking can appear okay on the surface.

Do you know anyone like this?

• A capable colleague who starts every day with a coffee spiked with whiskey.
• The parent at the school gates who always has a thermos of tea—but it’s really vodka and coke.
• A teacher who sips from a flask between lessons but effectively manages the students.
• The party animal who drinks everyone under the table but shows up for work the next day.
• A pub landlord who downs shots behind the bar but keeps the drinks coming and the customers happy.
• The barrister who is so suave and confident in court but can’t resist the urge to drink before and after hearings.
• A musician who knocks back booze before every show but always delivers impressive performances.
• The writer who can’t seem to put pen to paper without a glass of wine but never misses a deadline.
• The family member who always has a drink in hand but never loses their poise or charm.

Seeing the invisible: how to spot alcoholism in someone who seems functional

Functional alcoholics still fulfil their obligations in many areas of life but may exhibit red flags indicating their need for help. Do you, a family member or a friend experience agitation or nervousness when unable to drink, often drink more than intended, or experience withdrawal symptoms?

Functional alcoholism is hard to detect as people with this type of alcohol use disorder often appear to have everything together in their daily lives. It’s also not accurate to base your assessment solely on someone that drinks heavily. The UK is well notorious for its drinking culture, and there are many people who drink to excess without having an addiction to alcohol. Alcoholism is usually a coping mechanism for trauma that lingers deep beneath the surface, so it’s not easy to spot. Here are some signs that may indicate functional alcoholism:

• Drinking frequently, even in small amounts
• Drinking to cope with stress
• Consuming large amounts of alcohol without showing obvious signs of intoxication
• Drinking alone
• Denial of drinking
• Prioritising drinking over other activities
• Secretly drinking or hiding alcohol from family and friends
• Continuing to drink despite relationship problems, legal issues, or health concerns
• Experiencing withdrawal if alcohol stops being consumed

Of course, we are all different. Not every alcoholic will exhibit these signs. However, if you recognise these behaviours in yourself or a loved one, it is time to seek professional help.

The role of denial in high-functioning alcoholism

Denial runs deep in alcoholics. Many will deny that they have a problem with alcohol, even if they show signs of dependence. They may justify their drinking by pointing to the stressful nature of their work or other life circumstances. Emphasising that they pay their bills, look after their family, and only drink to unwind now and then can be ways of countering suggestions of alcohol misuse. However, the fact that they rely on alcohol physically and emotionally is a sign that they are not functioning healthily.

The impact of functional alcoholism on mental and physical health

Alcoholism can affect health, relationships, careers, and wellbeing. Long-term consequences include an increased risk of certain types of cancer, memory and learning problems, mental health conditions and weakened immunity.

While alcoholism is a mental health disorder, one aspect of this illness is physical dependence. This means uncomfortable withdrawal symptoms will occur when someone reduces their alcohol intake, as the brain has become accustomed to producing higher volumes of neurotransmitters to account for alcohol’s chemical imbalance. Functional alcoholics may try to quit independently because they don’t want to admit that they need support or they convince themselves that they can stop drinking whenever they want and don’t want anyone observing their alcohol intake. This can often lead to overdose, as the user attempts to counteract these feelings by drinking more alcohol. If alcohol levels in the blood drop too quickly, Post-Acute Withdrawal Symptoms (PAWS) is also a risk and can be highly dangerous.

In the long term, alcoholism can eat away at a person’s existence. While they may appear to be under control, their cravings for alcohol will increase over time, and they will need higher and higher volumes of alcohol in order to maintain their ‘high’. As cravings increase, that person will start to prioritise alcohol, abandoning their responsibilities and losing the little control they had over their routine. They may continue to want to fight their way out alone, convinced that they can function without support. This impacts not only that person’s life but can damage relationships and cause harm to others.

How to talk to a functional alcoholic about getting help

While functional alcoholics appear to manage in daily life, family members and loved ones are often aware of and concerned about their alcohol use. Alcoholism is an unforgiving illness, and functioning alcoholics will eventually stop functioning altogether.

Talking to a functioning alcoholic about getting help is a delicate matter that requires patience, compassion, and understanding. It’s essential to approach the conversation in a non-confrontational way and express your concerns for their wellbeing. Focus on the person’s behaviour and how it’s affecting you or others in their life. Avoid making accusations or placing blame, as this leads to defensiveness.

Start by expressing your love and support for them and your desire to help. Acknowledge their accomplishments and successes, but also express your concerns about their drinking habits and how it impacts their lives. When initiating the conversation, go for a time and place when they are sober and you have their full attention.

Encourage them to be honest about their drinking and how it affects their daily life. Listen to their thoughts and feelings, and avoid being dismissive or judgmental. Share any resources or support systems available to them, like counselling, support groups, or addiction treatment programmes.

It’s essential to show patience and empathy during the conversation. It may take time for them to recognise the harm their alcohol use is causing. Try to help them understand that seeking help is a sign of strength, not weakness.

A path to freedom: The reality of functioning

Although there is no quick fix to this complex condition, it can be effectively treated through an alcohol rehab programme and a comprehensive recovery plan. When a person admits to themself that they have lost control over their drinking, makes the decision to get support and develops new coping strategies, then, and only then, are they officially functioning.

To discover more about the treatment process and what Recovery Lighthouse can do to help you eliminate alcohol from your life, have a look at these resources.