Alcoholism can take a devastating toll on your physical health, your emotional well-being, your personal relationships, and your professional life. However, many alcoholics manage to function effectively, holding down jobs and maintaining households. They may hide their alcohol abuse for years without suffering any major losses. But under the surface, this form of alcoholism can cause severe psychological and emotional damage to the alcoholic and his or her loved ones.

There are at least two categories of people involved in alcoholism:

  1. Functioning alcoholics (high functioning alcoholics)
  2. Individuals who struggle with living a normal life as a result of their alcoholism.

If you’re the loved one of someone in either group, it’s important that you know how to deal with an alcoholic effectively, with consideration to their symptoms and lifestyle, if you want to help them get well. How to live with an alcoholic is another aspect to consider when dealing with such an individual.

What Is a High-Functioning Alcoholic?

When one hears the word ‘alcoholic’ for most people a picture comes to mind of someone whose life is in disarray because they drink too much. Not all alcoholics fall into this stereotype, however. There’s another type of alcoholic, the high-functioning alcoholic. High-functioning alcoholics often seem to have everything going for them. They drink too much, but they excel at work and have good relationships with family and friends. Their success often works against them, making them think they have their drinking under control based upon their achievements. Eventually, whether it takes months or years, alcoholism catches up with them.

Infographic detailing how to identify a high functioning alcoholic

What makes dealing with high-functioning alcoholics so challenging?

Functional alcoholics are often in deep denial about their problem. After all, they have managed to maintain the appearance of success in spite of their addiction. But most high-functioning alcoholics have friends or loved ones who help them cover up the consequences of their drinking. These individuals may unconsciously encourage, or enable, the alcoholic’s behavior by allowing the alcoholic to avoid the negative consequences of destructive drinking.

If you are involved with a functional alcoholic, you already know how painful it is to live with this disease. By getting help for yourself and your loved one, you may be able to avoid further consequences of alcoholism and build a healthier future for your family.

Identifying the Warning Signs

High-functioning alcoholics will rarely admit that they have a problem. But if someone in your life has three or more alcoholic beverages per day (two or more for women), he or she is consuming more than the recommended amount. The CDC defines moderate drinking as one drink per day for women, and up to two drinks per day for men. Binge drinking is defined as having four or more beverages in one drinking episode for women, and five or more beverages for men (a typical drinking episode is around two hours).

WebMD estimates that up to 20 percent of all alcoholics may be classified as “high-functioning.” High functioning alcoholics tend to display specific behaviors that can help you identify this problem:

Infographic detailing how they restrict their drinking

  • They restrict their drinking to specific times, situations, or beverages. You might hear a high-functioning alcoholic say, “I never drink on weeknights,” “I only drink at bars,” or “I only drink beer.” These self-imposed limitations might help the alcoholic convince himself that he is in control of his drinking when in fact, he often breaks his own rules.

Infographic detailing how high functioning alcoholic ask friends to cover for them

  • They ask friends or family to cover up for them. A high-functioning alcoholic might ask her husband to call in sick to work for her when she’s struggling with a hangover, or borrow money from a friend to pay bills when she’s spent too much on alcohol. In reality, high-functioning alcoholism is usually made possible through the enabling behavior of loved ones.

Infographic detailing high functioning alcoholics isolate themselves

  • They isolate themselves in their private time. High-functioning alcoholics may act sociable and outgoing at the office or at company parties. But when they’re not at work, they often prefer to spend their personal time drinking alone or at bars. They may even discourage their family from inviting guests to the house because they don’t want their drinking habits to be exposed.

Infographic detailing how functioning alcoholics break personal commitments

  • They break personal commitments because of their drinking. A functional alcoholic may receive awards at work for meeting high-performance standards, while forgetting an important anniversary or missing a family celebration because he or she was drunk or hungover.

Infographic detailing how a high functioning alcoholic may struggle with mental illness

  • They secretly struggle with mental illness. Many high-functioning alcoholics use their substance abuse to mask psychological disorders like depression, social phobia, or an eating disorder. They may suffer from anxiety about their competency or their material security. When they’re not under the influence, they may be moody, withdrawn, tearful, or irritable. They might even talk about suicide or attempt to harm themselves. According to the National Institutes of Health, approximately 25 percent of functional alcoholics struggle with depression.

Functional alcoholics are often intelligent, hardworking, and well-educated. Their professional status or personal success can make it hard to approach them about having a “problem” with alcohol. However, it is impossible to continue drinking heavily for a long period of time without suffering the physical and psychological consequences of alcoholism, such as liver disease, heart disease, neurological damage, cancer, or depression.

Avoiding the Trap of Codependency

Many of the spouses, significant others, parents, and children of high-functioning alcoholics fall into the trap of codependency, protecting the alcoholic from the consequences of the disease. Codependents sacrifice their own needs in order to maintain a facade of normalcy at home.

  • Typical codependent behaviors include:

    • Making excuses for the alcoholic’s actions: “I’m afraid she’s too sick to come to your party,” or “He’s really not that mean all the time; he’s just under a lot of stress.”
    • Covering the alcoholic’s expenses: Paying legal fees, traffic tickets, or fines that the alcoholic incurred.
    • Hiding the consequences of heavy drinking: Cleaning up messes or washing soiled clothes before the alcoholic is sober enough to see them.
    • Trying to manipulate the alcoholic into changing: Making emotional threats or using passive-aggressive behavior to make the alcoholic feel guilty.
    • Trying to control the alcoholic’s drinking: Keeping a large supply of alcohol at home or drinking with the alcoholic in order to keep an eye on him.
    • Pretending that your own needs don’t matter: Denying that the alcoholic has hurt you emotionally or physically, or that you weren’t disappointed by his or her failure to meet commitments.

Consciously or unconsciously, the codependent may help the alcoholic to continue drinking in order to maintain the status quo. Many high-functioning alcoholics earn a good living and are able to support their families while continuing to drink. Intervening in the addictive behavior may be seen as a threat to the family’s financial security — even if the family must put up with emotional neglect or physical abuse.

The National Council on Alcoholism and Drug Dependence notes that 67% of victims of violence by a former spouse or partner indicated that the offender was under the influence of alcohol. Further, 40 percent of child abusers admitted that they were drinking when they committed their offenses.

The best cure for codependency is a strong, healthy sense of self. Individual therapy, combined with and marriage or family counseling, can strengthen your self-esteem and help you build a healthy, sober relationship.

Seeking Support From Others

If someone close to you is a high-functioning alcoholic, it’s just as important to seek support for yourself as it is to get help for your loved one. You likely have questions about how to deal with an alcoholic, or how to help an alcoholic. Self-help organizations, church groups, and 12-step programs like Al-Anon and Alateen offer advice, hope, and encouragement to people involved with functioning alcoholics.

Alcoholism affects everyone in a household — not just the individual who drinks. Alcohol abuse increases the risk of physical and emotional violence, as well as substance abuse in other family members. An addiction therapist can help you find positive ways to deal with the stress of living with a functional alcoholic. If you have a problem with alcohol, a professional addiction treatment program is the most effective route to recovery.

Holding an Intervention

If the consequences of high-functioning alcoholism have become overwhelming, and your loved one refuses to seek help for alcohol abuse, it could be time to plan an intervention. An intervention is a planned meeting in which the concerned parties confront the alcoholic about his or her behavior.

  • The goals of an intervention include:

    • Getting the alcoholic to see how drinking has harmed her and her loved ones
    • Presenting the alcoholic with a plan for recovery
    • Proposing consequences if the alcoholic refuses to seek treatment
    • Helping the alcoholic take the right steps to go to treatment

    The participants in an intervention could include the alcoholic’s spouse or partner, children, parents, friends, coworkers, employer, friends, and other individuals who have been affected. A substance abuse counselor, family therapist, or spiritual advisor may also attend to provide an objective presence and to keep the agenda on track.

Although an intervention can take many forms, many of these meetings open with each participant stating how the alcoholic’s behavior has harmed or disappointed them. The alcoholic is then presented with a plan of care, including a proposal of consequences if he or she decides to refuse. For instance, the alcoholic may be denied visitation rights or may be faced with a marital separation if he decides not to seek help. An alcoholic in denial may become extremely manipulative, tearful, angry, or hostile when faced with the need for alcohol treatment. An experienced intervention specialist can help the participants prepare for these reactions, so that they can respond effectively.

Getting the Help You Need

Functional alcoholics differ from others who struggle with alcoholism, primarily in how alcohol affects their lives. Whether you have an alcoholic husband, wife or other loved one, you may be wondering how to help. An alcoholic can benefit from having an at-home support system before, during and after any form of treatment for their addiction. There are hundreds of resources all over the country designed to address the issue of alcohol abuse and addiction. These include 24-hour hotlines, and rehab and detox centers, including The Recovery Village.

Alcohol Treatment with Dr. Wandler