Alcohol addiction is usually linked to a specific set of experiences. These key alcohol symptoms can be helpful indicators to establish when someone may be in need of formal intervention, such as alcohol rehab. However, it is not always so easy to indicate when someone needs help in giving up alcohol. People who are perhaps more able to mask their symptoms are known as high-functioning alcoholics. These individuals may be able to present as though they are functioning ‘normally,’ meaning that their struggles go more or less undetected. However, this can delay access to appropriate alcohol help and lead to serious health effects. 

So, what are the key signs of high-functioning alcoholism? How can we differentiate between a high-functioning alcoholic as opposed to so-called ‘typical’ presentations? What are the characteristics of this type of addiction, and how can it be managed during alcohol addiction treatment?

What is high functioning alcoholism?

A ‘high functioning alcoholic’ is an individual dealing with addiction who appears to go about their day-to-day life without their dependency being detected. This ‘functional’ subtype is thought to make up 19.5% of alcoholics in the US. This means that high-functioning alcoholics appear to be ‘well-functioning adults’ and are more likely to conceal their relationship with alcohol. 

Factors influencing high functioning alcoholism 

Research published by the National Institute of health indicates that people with high-functioning alcoholism often fit the following description:

• Middle-aged 
• Well-educated
• Working a stable job 
• Have (and live with) their families 
• Around a third have experienced alcoholism in the family 
• Around a quarter have experienced depression 
• Around half frequently smoke cigarettes 

This suggests that high functioning alcoholics are more likely to be career-driven individuals. We can think of this type of alcoholism, then, as something that is experienced by white-collar workers. They may work in intense fields, such as in the corporate or business world, in industry, or in academia. The shared characteristic here is that these individuals often work in a role known for being stressful, and may be renowned for their performance and ability to ‘keep their cool’ under pressure. 

These individuals may be less likely to take sick leave, to miss deadlines, or to experience confrontation in the workplace. This is distinguishable from other forms of addiction, where a decline in performance at work is more common. 

The relationship between alcohol addiction and mental health 

Around a quarter of people struggling with alcohol addiction receive medication to treat a mental health condition. This is known as a dual diagnosis. Often, the symptoms arising from the mental health condition can lead to the development of addiction. This is because, for many people, drinking alcohol can be seen as a relatively ‘socially acceptable’ method of dealing with difficult feelings. The most common dual diagnoses in these contexts include:

• Anxiety 
• Depression 
• Bipolar disorder
• Sleep problems 
• Psychosis

Using alcohol as a coping mechanism can, for a short period, act to conceal the symptoms associated with some diagnosable conditions. However, when alcohol use starts to get out of hand, it can spiral, meaning that rather than being a ‘cure’ for mental health conditions or general stress, it actually starts to worsen it. This leads to two elements that need addressing. 

Risk of chronic health conditions 

High functioning alcoholism is less likely to be identified. An additional concern with this is that heavy drinking can be ongoing for much longer periods of time. This means that along with the psychological strain, the body can begin to show signs of alcohol-related harm. Heavy drinking for years (or in some cases, even decades) can take a considerable toll on the body, making individuals vulnerable to:

• High blood pressure 
• Heart disease
• Stroke
• Liver problems 
• Digestive issues 
• Increased risk of specific cancers 
• Weakened immune system
• Cognitive impairment 
• Increased risk of dementia

If unchecked for a long time, these conditions can become chronic. This then risks the development of life-changing or even life-threatening disease.

High functioning alcoholics: Barriers to treatment 

Unfortunately, we are not able to see into the inner lives of those around us. If someone appears to be doing well, achieving at work, appearing happy at home with their family with little or no sign of distress, it can be difficult to predict that they are struggling. This often means that high-functioning alcoholics do not enter treatment for longer periods of time. This may be because they have been able to conceal their dependency for longer or even because they themselves did not recognise that they were dealing with an addiction. This can limit access to appropriate healthcare and advice.

High-functioning alcoholics may also be able to minimise their experiences to make it seem that things are not as tough as they are – dropping this defence mechanism in order to reflect and access help honestly can be very difficult for a lot of people.

 

Alcoholism treatment for high-functioning alcoholics

Addiction rehab is available for all individuals, regardless of their situation. If you are dealing with high-functioning alcoholism, you may find the following forms of support particularly useful in  your recovery journey:

• Intervention 
• Alcohol counselling 
• Support groups 
• Family therapy
• Cognitive behavioural therapy 
• Alcohol detox 

The first step towards recovery is often the hardest. But in recognising and accepting you need help, you can build towards a life that leaves high-functioning alcoholism in the past.

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