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How do I know I’m a functioning alcoholic? Know the signs and symptoms

What to look out for in functioning alcoholics and how to get help if you’re struggling.

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What is a functioning alcoholic?

‘High-functioning alcoholics’, or ‘functioning alcoholic’, are colloquial terms for someone who's dependent on alcohol but is still able to function relatively effectively in their daily life. They'll be able to continue doing many of their daily tasks like going to work and looking after family members.

The term functioning alcoholic isn't a medical diagnosis. People experiencing this might properly be referred to as sufferers of alcohol use disorder, only that their symptoms don’t include a breakdown of their professional, social and family life – which are common signs of alcoholism.

You might hear the term ‘currently functioning’ used to emphasise that a person’s ability to function right now is unlikely to last. Alcohol addiction can have a devastating effect on someone’s life, but how long it takes someone’s drinking problem to affect their daily functioning will differ from person to person.

The picture of someone struggling with alcohol abuse disorder is often one where people struggle to live life normally as they battle a dependency on alcohol. For many people struggling with addiction this is true, but for someone with functioning alcoholism this isn’t the case.

Watch: signs and symptoms of alcoholism explained

Join our expert psychiatrist, Priory's Dr Renju Joseph, as he discusses the key signs and symptoms of alcoholism - informed by years of experience treating people with addiction issues.

Signs of a functioning alcoholic

Alcohol abuse can sometimes be confusing and difficult to spot, especially if a person appears to be capable of doing everything they need to maintain core aspects of their lives. They may perform well at work, have a pristine appearance and enjoy an active social life. While they may seem OK to the outside world, it’s likely that warning signs and symptoms are appearing elsewhere.

Some of the most common signs of a functioning alcoholic include the following:

  • Drinking heavily and excessively
  • Drinking alone, secretly or at unconventional times
  • Justifying their drinking as being a reward or celebration
  • Claiming they drink expensive alcohol to ‘prove’ they don’t have an addiction
  • Being unable to socialise without alcohol and avoiding social scenarios without alcohol
  • Experiencing blackouts - struggling to remember previous nights or days as a result of heavy drinking
  • Using alcohol to help deal with stress, anxiety, trauma, depression or loss
  • Making jokes or having a flippant attitude about their heavy drinking, or getting defensive and angry if they're challenged about it
  • Becoming aggressive, short-tempered and impulsive after drinking
  • Storing alcohol in secret  places, such as in their car, sheds, clothes or garage
  • Becoming irritable and restless if they're unable to drink for a day or two
  • An increasing tolerance to alcohol, meaning they need to drink more and more alcohol to feel any of the effects of alcohol
  • They experience some withdrawal symptoms when they stop drinking, such as nausea, headaches, fatigue, shaking, shivering and vivid dreams

Check your symptoms

Use our online alcohol testing tool to check your symptoms.

Functioning alcoholics in denial

Many people who suffer from alcohol use disorder struggle to acknowledge they've developed a dependence on the substance. This is especially true of functioning alcoholics. Unlike some sufferers, whose lives have been severely damaged due to alcohol, high functioning alcoholics may not be able to see significant consequences for their drinking.

This level of denial can be very tough to overcome and makes it difficult for a loved one to get through to the functioning alcoholic. If you’re concerned about a loved one’s relationship with alcohol, it’s important you approach the topic with compassion and at a time when they're sober.

There are things you can do to deal with an alcoholic partner. Be on the lookout for ways they try to rationalise their drinking, like:

  • “I’m successful, so how can my drinking be out of control?”
  • “I pay my bills, have lots of friends and have a good job”
  • “I only buy expensive alcohol”
  • “I haven’t suffered hardship or damage to my life due to alcohol”
  • "Everyone drinks like I do - it's normal"

Risk factors for a functioning alcoholics

America’s National Institutes of Health estimate that as many as 20% of all people suffering from alcohol addiction are high functioning. Most are described as well-educated with good incomes. If any of the factors below are familiar with you or someone you love, you might be at higher risk of becoming a functioning alcoholic.

  • If you’re under high levels of stress at work, home or have mental health struggles that you're not getting support for
  • Alcohol and depression are inextricably linked, with one often feeding into the other. If you have a common mental health disorder, such as depression, this could be a driver for an alcohol problem
  • Genetics are thought to play some role in causing alcohol addiction. If you have a close relative who struggles with alcohol use disorder, it could place you at higher risk
  • Frequently exceeding the weekly recommended alcohol intake of 14 units per week

“The vast majority of people who struggle with alcohol don’t necessarily look like they have a problem. People often come to me insisting ‘no-one at work knows about my alcohol problem’, but as they come through alcohol addiction treatment, it emerges that alcohol has often caused them quite significant work problems for years."

Dr Niall Campbell, Consultant Psychiatrist at Priory Hospital Roehampton.

How do I know I’m a functioning alcoholic?

The symptoms and risk factors above should help give you an idea of whether you, or someone you know, may be a functioning alcoholic.

Another way of knowing might be through screening tests. These question and answer tests can help you to understand your relationship with alcohol. They might be used by medical professionals as an indication of whether you need treatment for addiction.

One example is the alcohol use disorders identification test (AUDIT). Recommended by the National Institute for Health and Care Excellence (NICE), this 10-question screening tool can help to identify a drinking problem. It includes questions like:

  • How often do you have a drink containing alcohol?
  • How often during the last year have you found that you were not able to stop drinking once you had started?
  • How often during the last year have you had a feeling of guilt or remorse after drinking?
  • Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

Getting help for functioning alcoholism

As with anyone who's struggling with an alcohol dependency, acceptance is an initial but significant step. From here, there are many things you can do to help get you on a path to recovery.

Speak to someone you trust

Speaking about the issues you’ve been facing may seem small, but it’s an important step towards bringing your addiction under control. If you feel up to it, speak to a close friend or family member. They’ll be able to offer love and support when you most need it. A support network of loved ones around you will be very important during the recovery process.

If you’d prefer a professional opinion, speak to your GP. They can assess your symptoms and offer next steps, whether this is treatment or other methods of support. Alcohol addiction helplines are another useful place to head to. Groups like Alcoholics Anonymous (AA) or Drinkline offer free, confidential, over-the-phone advice and support for people who are concerned about their drinking.

Get some treatment

There’s no shame in accepting you need treatment for alcohol addiction. Treatments, like those listed below, can help you to overcome your dependency on alcohol and put you on path to a healthy future.

  • Alcohol detoxification – you can rid your body of addictive substances with a medically assisted detoxification from alcohol. This will help you to manage any potentially damaging withdrawal symptoms and allows you to fully focus on recovery through further treatment
  • Residential alcohol addiction treatment – residential inpatient care places you in an environment designed to aid in addiction recovery. During rehab, you’ll engage in therapy, support groups, wellbeing activities and other treatments aimed at securing long-term recovery from addiction. After a detox, many people will stay in residential treatment for up to 28 days
  • Therapy – dealing with underlying issues and learning to manage feelings through psycho-education is part of an effective recovery plan. Therapy will help you to do this. Therapy helps you to identify triggers and develop coping skills that allow you to move past cravings. This can be done on a 1:1 basis, with other family members, or as part of group therapy
  • Aftercare  – recovery from alcohol use disorder is a lifelong endeavour. Aftercare includes continued access to support groups, refreshing what you’ve learned in treatment and creating a ‘soft landing’ that helps you to cope with any triggers and temptations

Page clinically reviewed by Dee Johnson (Mbacp, MNCS), Addiction Therapist at Priory Hospital Chelmsford.

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