When People With Alcohol Use Disorder Function Well: A Hidden Problem

Reviewed Aug 31, 2017

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Summary

  • People with alcohol problems can fly under the radar due to their outward “success.”
  • Family members may sense something is wrong, but overlook it since there are compensating factors.

Many wouldn’t expect these two realities to co-exist in the same person at the same time: a high level of functioning and an alcohol use disorder. Yet it happens. Some people with alcohol use disorder fly under the radar and hide their drinking excesses fairly well. But they still have a very serious and potentially life-threatening condition.

Could you or a loved one fit this description?

What is high-functioning?

Alcohol use disorder is characterized by:

  • Increased tolerance
  • Presence of withdrawal symptoms
  • Drinking more and for longer than you intended
  • Giving up or reducing social or other activities in order to drink
  • Many unsuccessful efforts to cut down or control drinking

This definition cuts a pretty wide swath. It includes those who, at first glance, do not appear to be in distress or out of control as a result of drinking. Some who are dependent upon alcohol appear to be functioning very well, and, in many cases, even excelling in some visible aspect of their life.

Many go to work every day, attend church or synagogue, have families, exercise regularly, eat well, look good, don’t usually make fools of themselves in public, and/or have avoided legal problems. Yet they are drinking quite a bit and not without consequence.

All shapes and sizes

People with alcohol use disorder who function at a high level come in all shapes and sizes. Take the example of a well-paid executive who works long hours. When he is not working, he drinks—a lot. His family is grateful for the wonderful lifestyle his career provides and they don’t think they should expect much else from him. In other words, he is placed on a pedestal and left alone with his drinking. Friends and neighbors marvel at how successful he is, which further feeds his denial and fuels his alcohol use disorder.

As with other people with alcohol use disorder, these high functioners fail to see the extent to which their drinking affects others. The fact that they "function" and are able to provide material needs, or achieve in other aspects of their life or career, and still drink excessively is confusing for family members. Deep down they know something is wrong. But they’re not sure how to confront someone who has many fine qualities and is providing so well.

Because their families usually remain silent, these people believe that their drinking only impacts themselves. They believe their hard work and accomplishments have earned them the right to drink or reward themselves.

Still a family disease

One of the best ways to see the symptoms of alcohol use disorder is to look closely at the quality of the closest relationships. Here is where the truth emerges.

  • Spouses speak of their loneliness, feelings of rejection, embarrassment, and verbal abuse. When they try to confront the person with an alcohol use disorder, they are frequently accused of being unappreciative of all that is done for them.
  • Children describe feeling emotionally distant from and embarrassed by the parent with an alcohol use disorder.
  • Close friends and co-workers will describe mood swings that remain hidden from the casual observer.

This conspiracy of silence only enables the disease to progress.

Physical dependence

These people may or may not be physically addicted to alcohol. This is largely because, like many with alcohol use disorder, they don’t drink on a daily basis. But it is not how much or how often one drinks—it is what happens when one drinks that determines one’s relationship with alcohol.

Unlike those who occasionally overuse alcohol, those with alcohol use disorders routinely experience loss of control, hangovers, relationship problems, and even blackouts as a result of their drinking. But they are good at covering it up, or are surrounded by enablers who help them cover up.

Blessing or curse

The problem is that the high level of functioning is really a façade, which keeps these individuals from experiencing painful consequences that may change their life. For example, the threat of a divorce or job loss is just the thing that forces many people with an alcohol use disorder into getting help. Being protected by one’s status or money may sound like a good thing, but the reality is people with alcohol use disorder who achieve at a high level (and their families) may actually have a problem longer as a result.

What to do

Stop enabling. Unfortunately it is usually a crisis of conscience that awakens a person with an alcohol use disorder in denial. For many spouses, simply refusing to drink with them sends a very clear message. Or not attending social functions when there will be a lot of drinking. Saying in your own words, “I love you but hate your drinking and will not participate anymore,” is a good start. If you are worried about your drinking or a loved one’s drinking, explore the resources on this site and/or call the toll-free number on this site and talk with a health professional about other ways to help your loved one.

By Drew W. Edwards, MS, EdD
Reviewed by Enrique Olivares, MD, FAPA, Director of Addiction Services, Beacon Health Options

Summary

  • People with alcohol problems can fly under the radar due to their outward “success.”
  • Family members may sense something is wrong, but overlook it since there are compensating factors.

Many wouldn’t expect these two realities to co-exist in the same person at the same time: a high level of functioning and an alcohol use disorder. Yet it happens. Some people with alcohol use disorder fly under the radar and hide their drinking excesses fairly well. But they still have a very serious and potentially life-threatening condition.

Could you or a loved one fit this description?

What is high-functioning?

Alcohol use disorder is characterized by:

  • Increased tolerance
  • Presence of withdrawal symptoms
  • Drinking more and for longer than you intended
  • Giving up or reducing social or other activities in order to drink
  • Many unsuccessful efforts to cut down or control drinking

This definition cuts a pretty wide swath. It includes those who, at first glance, do not appear to be in distress or out of control as a result of drinking. Some who are dependent upon alcohol appear to be functioning very well, and, in many cases, even excelling in some visible aspect of their life.

Many go to work every day, attend church or synagogue, have families, exercise regularly, eat well, look good, don’t usually make fools of themselves in public, and/or have avoided legal problems. Yet they are drinking quite a bit and not without consequence.

All shapes and sizes

People with alcohol use disorder who function at a high level come in all shapes and sizes. Take the example of a well-paid executive who works long hours. When he is not working, he drinks—a lot. His family is grateful for the wonderful lifestyle his career provides and they don’t think they should expect much else from him. In other words, he is placed on a pedestal and left alone with his drinking. Friends and neighbors marvel at how successful he is, which further feeds his denial and fuels his alcohol use disorder.

As with other people with alcohol use disorder, these high functioners fail to see the extent to which their drinking affects others. The fact that they "function" and are able to provide material needs, or achieve in other aspects of their life or career, and still drink excessively is confusing for family members. Deep down they know something is wrong. But they’re not sure how to confront someone who has many fine qualities and is providing so well.

Because their families usually remain silent, these people believe that their drinking only impacts themselves. They believe their hard work and accomplishments have earned them the right to drink or reward themselves.

Still a family disease

One of the best ways to see the symptoms of alcohol use disorder is to look closely at the quality of the closest relationships. Here is where the truth emerges.

  • Spouses speak of their loneliness, feelings of rejection, embarrassment, and verbal abuse. When they try to confront the person with an alcohol use disorder, they are frequently accused of being unappreciative of all that is done for them.
  • Children describe feeling emotionally distant from and embarrassed by the parent with an alcohol use disorder.
  • Close friends and co-workers will describe mood swings that remain hidden from the casual observer.

This conspiracy of silence only enables the disease to progress.

Physical dependence

These people may or may not be physically addicted to alcohol. This is largely because, like many with alcohol use disorder, they don’t drink on a daily basis. But it is not how much or how often one drinks—it is what happens when one drinks that determines one’s relationship with alcohol.

Unlike those who occasionally overuse alcohol, those with alcohol use disorders routinely experience loss of control, hangovers, relationship problems, and even blackouts as a result of their drinking. But they are good at covering it up, or are surrounded by enablers who help them cover up.

Blessing or curse

The problem is that the high level of functioning is really a façade, which keeps these individuals from experiencing painful consequences that may change their life. For example, the threat of a divorce or job loss is just the thing that forces many people with an alcohol use disorder into getting help. Being protected by one’s status or money may sound like a good thing, but the reality is people with alcohol use disorder who achieve at a high level (and their families) may actually have a problem longer as a result.

What to do

Stop enabling. Unfortunately it is usually a crisis of conscience that awakens a person with an alcohol use disorder in denial. For many spouses, simply refusing to drink with them sends a very clear message. Or not attending social functions when there will be a lot of drinking. Saying in your own words, “I love you but hate your drinking and will not participate anymore,” is a good start. If you are worried about your drinking or a loved one’s drinking, explore the resources on this site and/or call the toll-free number on this site and talk with a health professional about other ways to help your loved one.

By Drew W. Edwards, MS, EdD
Reviewed by Enrique Olivares, MD, FAPA, Director of Addiction Services, Beacon Health Options

Summary

  • People with alcohol problems can fly under the radar due to their outward “success.”
  • Family members may sense something is wrong, but overlook it since there are compensating factors.

Many wouldn’t expect these two realities to co-exist in the same person at the same time: a high level of functioning and an alcohol use disorder. Yet it happens. Some people with alcohol use disorder fly under the radar and hide their drinking excesses fairly well. But they still have a very serious and potentially life-threatening condition.

Could you or a loved one fit this description?

What is high-functioning?

Alcohol use disorder is characterized by:

  • Increased tolerance
  • Presence of withdrawal symptoms
  • Drinking more and for longer than you intended
  • Giving up or reducing social or other activities in order to drink
  • Many unsuccessful efforts to cut down or control drinking

This definition cuts a pretty wide swath. It includes those who, at first glance, do not appear to be in distress or out of control as a result of drinking. Some who are dependent upon alcohol appear to be functioning very well, and, in many cases, even excelling in some visible aspect of their life.

Many go to work every day, attend church or synagogue, have families, exercise regularly, eat well, look good, don’t usually make fools of themselves in public, and/or have avoided legal problems. Yet they are drinking quite a bit and not without consequence.

All shapes and sizes

People with alcohol use disorder who function at a high level come in all shapes and sizes. Take the example of a well-paid executive who works long hours. When he is not working, he drinks—a lot. His family is grateful for the wonderful lifestyle his career provides and they don’t think they should expect much else from him. In other words, he is placed on a pedestal and left alone with his drinking. Friends and neighbors marvel at how successful he is, which further feeds his denial and fuels his alcohol use disorder.

As with other people with alcohol use disorder, these high functioners fail to see the extent to which their drinking affects others. The fact that they "function" and are able to provide material needs, or achieve in other aspects of their life or career, and still drink excessively is confusing for family members. Deep down they know something is wrong. But they’re not sure how to confront someone who has many fine qualities and is providing so well.

Because their families usually remain silent, these people believe that their drinking only impacts themselves. They believe their hard work and accomplishments have earned them the right to drink or reward themselves.

Still a family disease

One of the best ways to see the symptoms of alcohol use disorder is to look closely at the quality of the closest relationships. Here is where the truth emerges.

  • Spouses speak of their loneliness, feelings of rejection, embarrassment, and verbal abuse. When they try to confront the person with an alcohol use disorder, they are frequently accused of being unappreciative of all that is done for them.
  • Children describe feeling emotionally distant from and embarrassed by the parent with an alcohol use disorder.
  • Close friends and co-workers will describe mood swings that remain hidden from the casual observer.

This conspiracy of silence only enables the disease to progress.

Physical dependence

These people may or may not be physically addicted to alcohol. This is largely because, like many with alcohol use disorder, they don’t drink on a daily basis. But it is not how much or how often one drinks—it is what happens when one drinks that determines one’s relationship with alcohol.

Unlike those who occasionally overuse alcohol, those with alcohol use disorders routinely experience loss of control, hangovers, relationship problems, and even blackouts as a result of their drinking. But they are good at covering it up, or are surrounded by enablers who help them cover up.

Blessing or curse

The problem is that the high level of functioning is really a façade, which keeps these individuals from experiencing painful consequences that may change their life. For example, the threat of a divorce or job loss is just the thing that forces many people with an alcohol use disorder into getting help. Being protected by one’s status or money may sound like a good thing, but the reality is people with alcohol use disorder who achieve at a high level (and their families) may actually have a problem longer as a result.

What to do

Stop enabling. Unfortunately it is usually a crisis of conscience that awakens a person with an alcohol use disorder in denial. For many spouses, simply refusing to drink with them sends a very clear message. Or not attending social functions when there will be a lot of drinking. Saying in your own words, “I love you but hate your drinking and will not participate anymore,” is a good start. If you are worried about your drinking or a loved one’s drinking, explore the resources on this site and/or call the toll-free number on this site and talk with a health professional about other ways to help your loved one.

By Drew W. Edwards, MS, EdD
Reviewed by Enrique Olivares, MD, FAPA, Director of Addiction Services, Beacon Health Options

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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