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The Truth About High-Functioning Alcoholics

The Truth About High-Functioning Alcoholics

The average Indian consumes 11.4 litres of alcohol every year, and about 30% of India’s population are regular drinkers. On the WHO’s ‘Years of Lost Life’ (YLL) scale, which is a measure of premature mortality, India was placed at 4 on a scale of 1 to 5, for premature deaths caused by alcohol consumption. 


Are You An Alcoholic?



Alcoholism comes in many forms and the terms alcohol abuse and alcoholism are often interchangeably used in common conversations. However, alcoholism refers to alcohol dependence when a person feels a compulsion to drink continuously. Alcohol abuse, on the other hand, is a pattern of behaviour when a person drinks in heavy amounts despite negative consequences.


Here are some warning signs of alcoholism:

  1. Drinking alone 
  2. Losing interest in other activities
  3. Craving for Alcohol
  4. Prioritising drinking
  5. Alcohol withdrawal symptoms (sweating, anxiety, etc.)
  6. Irritable behaviour and extreme mood swings
  7. Feelings of guilt while drinking
  8. Drinking first thing in the morning
  9. Continuing consumption, despite problems


Alcoholism can take a major toll on your personal life and health. However, there are people who manage to maintain their lives as it is, despite alcohol abuse for years. They are called ‘high-functioning alcoholics’. Their major problem lies in denial due to no losses or changes because of alcohol consumption. They believe they have their drinking under control. 


Recognising A High-functioning Alcoholic



The Centre for Disease Control and Prevention defines moderate drinking as up to two drinks per day for men and one drink per day for women. But if someone is consuming more than that on a daily basis, he or she may be a borderline alcoholic. High-functioning alcoholics tend to exhibit certain behavioural patterns such as:


  1. They pose self-restrictions such as drinking at specific times, choice of alcohol, and situations.
  2. They often ask friends or family to cover up for them. Most high-functioning alcoholism is triggered by the enabling behaviour of loved ones.

  3. They like to stay alone in their free time. High-functioning alcoholics may be social and outgoing at work or gatherings, but they prefer drinking alone otherwise.
  4. They miss personal commitments because of their drinking. He or she may forget an important family or personal occasion because of a night of heavy drinking.
  5. They may be secretly struggling with a mental illness. High-functioning alcoholics are intelligent and hard-working. However, they may be hiding symptoms of anxiety, depression, or suicidal tendencies behind their alcoholism. 

  6. According to the National Institutes of Health, around 25% high-functioning alcoholics struggle with depression.


What Are The Health Risks For High-functioning Alcoholics?



High-functioning alcoholics may seem to have everything in control, but behaviours such as drinking and driving, and blacking out are only some risk-inducing behaviours. 

Health risks involve:

  1. Liver disease
  2. Pancreatitis
  3. Some forms of cancer
  4. Brain damage
  5. Loss of memory


Alcohol abuse can lead to behaviours of domestic violence, sexual abuse, suicide, child abuse and neglect, and fetal alcohol syndrome.


Getting Treated For Alcoholism



Addiction takes a toll at some point in your life, no matter how high-functioning you may be. As the addiction gets increasingly problematic, health, family, finances, and professional lives start to see the differences. Like any other serious illness, alcohol addiction may seem less threatening in the onset but typically grows beyond your control if not checked early on.


Just how many addiction treatments require counselling and conscious changes in behaviours, so does treatment for an alcoholic. De-addiction centres, Alcoholics Anonymous, psychiatrists, and addiction specialists can guide you along your journey to recovery. Relating to and discussing with other alcoholics can often be a stepping stone to break through the denial. 


How to Care for a High-functioning Alcoholic



Living with an alcoholic is never an easy choice. However, if your loved one or partner is showing signs of alcoholism, here’s what you can do:

  1. Enabling vs setting boundaries: Trying to keep them happy is no way to help them. Restrict or set boundaries if you’re living under the same roof, and distract them with other activities or topics of conversation whenever they feel the urge to drink
  2. Understanding a harmful living situation: Abuse, in no form, is acceptable. Ensure your partner’s alcoholic behaviour doesn’t lead to any form of violence. If there have been outbursts, it’s time to take them to a therapist
  3. Confrontation and Intervention: Choose a time when they’re sober and bring up the topic. The idea is to not blame anybody but to redirect their focus on the larger picture of well-being and health
  4. Professional Counselling: It may be difficult in the beginning to convince an alcoholic to seek help, but give it your best shot and take professional help as soon as necessary

You can’t expect changes to happen overnight, either with yourself or with a partner who is a high-functioning alcoholic. However, constant support and understanding can go a long way.

Early treatment leads to better outcomes, and also prevents you and your loved ones from going through pain that comes with functional deterioration. With the right help in the right environment, you can come out of your alcoholism and resume a new healthy life.






Medanta Medical Team
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