For many people in society, often due to generations of stigma, an “alcoholic” or an “addict” (what we now refer to as a person with a substance use disorder) was thought of as an individual who had ruined their lives due to drinking and using drugs. Often, they were thought of as dirty, down on their luck, and possibly homeless. They were thought of as a person uncapable of employment or keeping a job, having difficulty financially, and did not have a deportment of emotional stability. They were of poor character, low morals, and weak-willed. While often untrue, this was the prevailing belief of what it was to be a person suffering from alcoholism or addiction.
Because of this prevailing caricature, society and much of the media needed a terminology to define other people in society that also suffering from alcoholism or addiction. Because not every person that dealt with substance use disorder fit the profile of the stigmatized “addict” or “alcoholic.” So then, how was society to define those people with alcoholism or who lived in active addiction that didn’t fit into that preconceived box of someone who drinks too much or uses drugs? What was the name of the person with alcoholism that was employed? Who was still married with children? Who, on the outside, may have even looked to be successful and thriving? If an alcoholic was a poor, homeless person incapable of employment and long-term human connections that lived on the edge of society, what then was the individual who looked like, from the outside, that everything in their life was working even though they drank alcoholically or lived in active addiction? That term became known as “the functional alcoholic.”
So, what is a functioning alcoholic? A functional alcoholic, or what some people term a “high-functioning alcoholic” or a “high bottom alcoholic”, is a person who seemingly has a successful or manageable life from the outside, but who internally is suffering from the physical, mental, emotional, and spiritual aspects of alcoholism or addiction. A functional alcoholic is someone who may be dependent on alcohol (or other substances), but who rarely demonstrates that alcohol or other substances are a problem because they rarely miss work, lose a job, get behind on bills, and meet family and other social obligations. They are a person who may use alcohol or drugs to a dangerous degree, but whose life doesn’t seem from the outside looking in to be impacted negatively. In short, a functional alcoholic is an alcoholic who is seemingly functioning successfully in society and managing their life as well as most other people do, and in some cases, even managing it more successfully.
However, as a person that has suffered from addiction or alcoholism will report, even if everything on the outside looks good, there is always internal suffering. Often, functional alcoholics drink or use in isolation, so there is often a disconnect with others and society. Even more so, there is suffering that other people cannot see, such as mental health issues like anxiety and depression (or even higher acuity psychiatric or psychological issues), there is often self-esteem issues or issues of guilt and shame, often relationships suffer behind closed doors, and there are overriding feelings of loneliness, frustration, fear, bewilderment, and despair. What other people also don’t see are the repeated attempts and failures to quit drinking or using drugs, difficult and uncontrollable cravings, and obsessive and compulsive thinking. It is important to remember that the word “functional” in functional alcoholic only refers to the outward appearance and behaviors and doesn’t reflect on the internal struggle that impacts the individual’s physical, mental, emotional, and spiritual condition.
So, what are some signs of a person that has alcohol use disorder (AUD) but might be considered at “functional alcoholic?”
- If the person’s first thought or action when dealing with stress or other uncomfortable emotions is to reach for a drink
- If the person drinks regularly or drinks every single day, but still functions at their job or dealing with family responsibilities
- Someone who regularly takes more drinks than they intended to, or drinks longer than they intended to, such as going to a bar to have “one drink with friends” and instead staying much longer and getting drunk
- Multiple DUI or DWI incidents
- If a situation or circumstance prevents the person from drinking, such as a family gathering or a business meeting, does the person get angry, agitated, irritable, nervous, or overall discontented emotionally?
- If the first thought after a life circumstance or responsibility or event is to have a drink
- If all social situations or circumstances outside of work or family involve drinking
- Blacking out from drinking
- If other people in the person’s life have confronted or regularly confront the person about or because of their drinking
- Hiding alcohol use, amount or consumption of alcohol use, or lying about alcohol use
- Experiencing physical withdrawal symptoms when having to stop drinking alcohol
- If the person becomes angry or defensive when confronted about their drinking
- If, over time, the person’s tolerance for alcohol has increased
- Having medical complications that are caused by drinking, such as cognitive impairment or alcohol-related organ damage
- If the person’s doctor or physician (or another medical professional) has expressed concern over their alcohol use
One of the biggest issues for any alcoholic is denial. It is one of the reason’s taking steps towards sobriety and finding recovery is so difficult for anyone with an addiction or alcohol issue- they simply have a difficult time admitting to having a problem or that the problem is big enough or dangerous enough that they need to take steps to stop the behavior. A functional alcoholic may suffer from even more denial than someone with a drinking problem who isn’t functioning, because in their mind, they have evidence that supports they aren’t suffering consequences from their drinking. Often, functional alcoholics will point to things like their job, their income, their paid bills, their fulfilled and met life responsibilities or family obligations as a means to demonstrate that they are fine and don’t need help for their drinking. Mountains of evidence is used to state their case that they are functional, and therefore not an alcoholic. Because there are no severe consequences, at least ones that can be seen from the outside looking in, the denial in functional alcoholics becomes deeply ingrained and is difficult to overcome.
However, as mentioned before, if someone is a functional alcoholic, there is no doubt that if they have a moment of clarity and become honest with themselves, they will no doubt find that they are actually suffering from many consequences. Those consequences however are internal and not external or material. They will often find that they are lonely, that they are suffering from mental health issues like anxiety or depression, that they have had trouble or problems in their personal relationships or relationships with family members, or that they are often paralyzed in many ways by fear. Furthermore, if you asked the close family members and friends of functional alcoholics, the feedback that they give also is of concern; that their loved one has become distant or difficult, and that they are concerned about their drinking and their well-being. Having a job or being married or able to pay bills is important, but it does not guard against the true consequences of alcoholism. No matter how functional someone looks from the outside, if they are suffering from alcoholism or alcohol use disorder, their internal life is also suffering, and they are in need of help as anyone else dealing with addiction.
If you or someone you know needs help for addiction or co-occurring disorder issues, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive dual diagnosis addiction treatment in the Mid-Atlantic area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs. Please give us a call at (410) 773-0500 or email our team at info@marylandaddictionrecovery.com. For more information on all of our drug addiction, alcohol addiction and co-occurring disorder services and recovery resources, please visit our web site at www.marylandaddictionrecovery.com.