The Symptoms of The High-Functioning Alcoholic

When people think about alcoholism and those who are caught up in alcohol abuse, the scenes that are painted in their mind are bold and dramatic. Images of people who are destitute with no money, no jobs, and estranged from their families come to mind. Additionally, more drastic images can come to mind such as failing health, homelessness, jail, institutions and death.

Indeed, these outcomes can definitely occur as the result of alcoholism, but the definition of alcoholism itself isn't so cut and dry. In reality, alcoholism can be seen as existing on a continuum and there can be those who struggle with alcohol abuse but appear to have it together on the surface.

You may know people who are the picture-perfect parent or employee. They take the kids to school, work a dream job, pay the bills on time and are successful multi-taskers of the highest degree. Beneath this seemingly flawless facade, however, there are things that aren't adding up. You may notice that your friend or co-worker can't seem to go a day without hitting up the happy hour after work. You may notice they seem to be preoccupied and talk about alcohol almost non-stop. No matter what the social or family function may be, they are always with a drink in hand.

If you are noticing these signs, they may be pointing to the fact that your friend may be a high-functioning alcoholic. The high-functioning alcoholic doesn’t fit neatly within the set stereotypes of a drunk. They are successful, well-adjusted and happy, but just beneath those first impressions they are waging a private struggle with alcohol, and they may be walking on the slimmest of threads.

The following are some of the most common symptoms seen in the high-functioning alcoholic.

A Change in Friends

Much like others who struggle with alcohol, the high-functioning alcoholic's circle of friends may change. They may surround themselves with people who drink on a regular basis and will attend events in which alcohol is front and center.

For the high-functioning alcoholic, they may pride themselves on the fact they don't drink during the day or don't show up to work or family functions drunk, but in any social situation where there is alcohol present they are right in the middle of the action.

Alcohol Seems to Always Be On Their Mind

High-functioning alcoholics have a healthy obsession on when and where they are going to have their next drink. While at work, they may be counting down the hours and minutes until the work day is over and they can hit happy hour or get home and make a beeline to the liquor cabinet.

They may be rummaging through their wallet and taking inventory of their available cash wondering if they have enough to last the night. Additionally, those who are high-functioning alcoholics may know in their mind how much they can actually drink before they appear drunk to others.

They Can't Stop At Just One Drink

Another symptom that the high-functioning alcoholic displays is the fact they don't have the capacity to stop after just one drink. You may often see them refuse drinks in a social situation, but they are more than likely waiting to get home where they can continue drinking without further scrutiny.

If they do have a drink, chances are pretty good  they won’t stop until the night is done. The high-functioning alcoholic is a pro at hiding their problem and will deny they even have a problem.

Guilt and Shame

For those who are high-functioning alcoholics, they will feel tremendous guilt and shame if their alcoholic behaviors become noticeable to others. They go to great lengths to conceal their issues, and when they act inappropriately as a result of drinking they feel remorseful. While this guilt and shame should provide the impetus for the high-functioning alcoholic to take a deeper look into themselves, they will instead try even harder to mask their issues with alcohol.

Living Two Lives

The high-functioning alcoholic is the master of compartmentalizing their life. On the one hand, they have their everyday normal life in which they are the model employee, spouse and parent.

On the other hand, they have their drinking life where they can be a completely different person. As stated previously, the high-functioning alcoholic goes to great lengths to ensure these two disparate lives don't intersect.

They Try to Quit On Their Own and Are Unsuccessful

Like others who struggle with alcohol dependence and abuse, the high-functioning alcoholic has more than likely made several attempts to quit drinking on their own. Left to their own devices, they return to drinking after a short period and they basically pick up where they left off.

Even though the fact they are contemplating quitting alcohol triggers at least some form of deeper thinking into their issues, the high-functioning alcoholic will continue to drink and rationalize their drinking by pointing out that it hasn't affected their personal or professional life.

If This Sounds Like You or Someone You Love

"High-functioning alcoholic" is a description, not a diagnosis, and it can mislead in both directions. Holding down a job and a family does not rule out alcohol use disorder; clinicians diagnose by pattern, not by whether life has fallen apart. NIAAA's criteria count how many of eleven symptoms apply in a year, and the number, not the outward success, sets the severity. Our page on the signs of alcohol use disorder walks through each one, and the optional alcohol self-assessment can help you think it through. It is educational and cannot tell you whether it is safe to stop on your own.

A few questions people in this situation find clarifying: Do you plan your day around when you can drink? Have you set rules for yourself (only after six, only on weekends) and broken them? Do you drink more when no one is watching? Have you tried to stop and gone back within days? Does the idea of a week without alcohol feel unreasonable?

If you are the one drinking, the safest next step is a conversation with a clinician, because stopping suddenly after long heavy drinking can be dangerous. NIAAA warns that withdrawal after prolonged heavy drinking can include seizures, and doctors can prescribe medication that makes it safer. Our guide to getting sober from alcohol explains how to plan it, and treatment ranges from outpatient counseling to residential care depending on what the assessment shows.

If you are the spouse, friend, or coworker, pick a private, sober moment, describe specific things you have seen rather than a label, and say what you are worried about. Expect denial the first time. You cannot make someone stop, but you can decline to cover for them and you can get support for yourself. See how to support a loved one with addiction.