Are You A Functioning Alcoholic?
What Does It Mean To Be A Functioning Alcoholic?
A functioning alcoholic is a non-medical term for people dependent on alcohol but still able to hold their lives together. This means the person can maintain employment and get through necessary life activities (e.g., paying bills, keeping a social life).
Often, these individuals are high-functioning individuals who have learned to "mask" their difficulties. While they may not show all the traditional signs of alcohol addiction, they still suffer many of the same negative consequences.
This article covers the essentials of this topic. We also identify treatment options for people concerned about their drinking.
Signs And Symptoms Of Functional Alcoholism
Functional alcoholism is a bit of a misnomer. The truth is that no one truly functions well when they're struggling with alcohol dependency. That said, some people are better able to hide the signs of a drinking problem than others.
Most of us have demanding professional and personal schedules. What's more, life is full of stressors and worries. Alcohol is self-medication for stress. The pleasant effects we get through distraction and intoxication often drive frequent use. So, it’s not surprising increased alcohol use is associated with factors like long work hours (1).
Holding down a relatively stable life can mask struggles with alcohol. There are many signs and symptoms of functional alcoholism that family, friends, and co-workers can look out for. Some of these signs and symptoms of an alcohol use disorder include:
Drinking more than intended or more often than planned.
Needing to drink increasing amounts for the same effect (tolerance to alcohol).
Experiencing withdrawal symptoms (e.g., shaking, sweating).
Neglecting responsibilities at work or home in favour of drinking or recovering from a hangover.
Drinking in secret or lying about consumption quantity.
Withdrawing from social activities or hobbies that don't revolve around drinking.
Having financial, legal, or relationship problems as a result of drinking.
Needing alcohol to relax.
Feeling guilty or ashamed about drinking habits but being unable to cut back.
What Causes Alcoholism?
There is no single cause of alcohol use disorders (AUD). Instead, a combination of factors is usually at play. Here is a short overview of common elements.
Genetic
Studies have shown that variations in specific genes can make people more susceptible to developing alcoholism.
For example, a gene called ADH1B helps to encode an enzyme that assists the breakdown of alcohol in the liver. Variations in this gene have been linked with an increased risk of alcoholism (2).
Variations in another gene called BDNF have also been linked with an increased risk for alcoholism. This gene encodes a protein that helps protect nerve cells from damage. Low levels of BDNF have been associated with an increased risk for alcoholism.
Social factors
While genetics may make some people more vulnerable to alcoholism, it does not mean that addiction is inevitable. Many social factors can play a role in alcohol use problems. For example, peer pressure and socioeconomic status can contribute to problem drinking.
Environmental
Environmental factors also play a role in the development of alcoholism. For example, growing up in homes where alcohol was abused can lead to problems in adult life. This situation 'normalises' unhealthy drinking.
Psychological
Several psychological factors can contribute to the development of alcoholism.
For example, people who suffer from mental health problems like depression or anxiety may turn to alcohol. This can lead to drinking problems down the road. In addition, people with certain medical conditions like chronic pain often turn to alcohol as a coping strategy. Unfortunately, using alcohol in this way can lead to dependence and addiction.
How Can Alcoholism Be Treated?
Alcohol use disorders are huge public health issues. Rates of alcoholism are as high as 20% in some countries (4)
Alcoholism is a serious condition that requires professional treatment to be effectively addressed. Treatment for high-functioning alcoholics encompasses several options. Potential interventions to stop drinking include:
Detoxification programs
Medication (e.g., naltrexone)
Talking therapies and counselling
Self-help and support groups (e.g., Alcoholics Anonymous)
Inpatient rehabilitation programs ('alcohol rehab') in a treatment facility.
The critical first step is recognising a problem and seeking help from a qualified professional. If you or someone you know may be struggling with functional alcoholism, please reach out for help. Many resources are available to help you get the help you need.
Talking therapies are an important treatment option. CBT and MI are common approaches used for alcohol problems.
Cognitive-Behavioral Therapy (CBT)
One of the most popular and effective psychological treatments for alcoholism is Cognitive Behavioral Therapy (CBT). CBT is a therapy that helps people change their thinking and behaviour patterns. CBT for alcoholism treatment typically focuses on helping the individual to identify and avoid triggers that may lead to drinking. This approach also helps people develop healthy coping mechanisms for dealing with stressors.
Motivational Interviewing
Motivational interviewing (MI) is another commonly used psychological approach for alcoholism. MI is a style of counselling that helps people to explore their ambivalence about change. MI ultimately aims to help people commit to behaviour change.
The practitioner will help the individual to discuss their goals, values, and reasons for wanting to change their drinking behaviour. MI can be very effective in helping people to commit to abstinence from alcohol.
Summary
While functional alcoholism may not look like conventional alcoholism, it is still a serious condition. If you think you or someone you know may be suffering from functional alcoholism, please reach out for help. With treatment, it is possible for those suffering from functional alcoholism to recover and live sober, happy, and fulfilling lives.
Lots of additional information can be found online. Examples include:
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References
(1) Virtanen M, Jokela M, Nyberg S T, Madsen I E H, Lallukka T, Ahola K et al. Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data BMJ 2015; 350 :g7772 doi:10.1136/bmj.g7772
(2) Li, D., Zhao, H., & Gelernter, J. (2011). Strong Association of The Alcohol Dehydrogenase 1B Gene (ADH1B) With Alcohol Dependence And Alcohol-induced Medical Diseases. Biological psychiatry, 70(6), 504. https://doi.org/10.1016/j.biopsych.2011.02.024
(3) Pandey, S. C. (2016). A Critical Role of Brain-Derived Neurotrophic Factor in Alcohol Consumption. Biological psychiatry, 79(6), 427. https://doi.org/10.1016/j.biopsych.2015.12.020
(4) https://worldpopulationreview.com/country-rankings/alcoholism-by-country