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Relationships are complex, layered, and it takes a lot for a husband or a wife to make it work and keep the family structure healthy and whole. Alcohol use disorders, binge drinking, problematic drinking, and alcoholism can be devastating to families and relationships if allowed to continue. Ultimately, no matter who it is in your life with a drinking problem, their struggles with alcohol can be exacerbated if they do not receive timely intervention.
If you are observing warning signs of functional alcoholism and see it getting worse, it may be time to ask for help.
Recognizing the Signs of a Functioning Alcoholic
According to the National Institute of Health, functioning alcoholics are predominantly middle-aged, have steady jobs, and family history of alcoholism. These are not hard and fast rules, and there are many other telling signs you can look for as identifiers in daily life. These can include:
Drinking During the Day
This is a pattern that should be monitored if it persists routinely. Having a beer with lunch, or celebrating a holiday during the daytime is far different than routinely having drinks during the day. Make sure to take connected symptoms such as lying about drinking, or hiding their actions seriously. An opposite warning symptom can be an attempt to make light of drinking often in order to normalize it.
Denial or Avoidance
An alcoholic is unlikely to admit they have a dependency or issues resulting from it. They may go far out of their way to hide behaviors or avoid conversations. Over time this can teach those connected to the alcohol user not ask as they will get no answer. They may flip the script and make you feel bad for asking. Admitting a problem is the first step to changing it, and positive recognition from a functional alcoholic when they do is a huge first step.
Keep in mind, admitting there is a problem is victory. Without follow through to address the problem is manipulation and false hope. Some alcohol users feel admitting there is a problem is what a family needs to hear and is enough for them to back off for a while. Families can get stuck in a holding pattern or waiting game while waiting for the day they address the admitted problem.
Denial, Avoidance, Coverups & Lies Go Both Ways in a Functional Alcoholic Relationship Between Two People
Drinking as a Coping Mechanism
This [Drinking to Cope with Stress] can be alone or in a group setting, though it will usually manifest in the former for functional alcoholics. While a drink as stress relief in moderation is typical for many adults, it is important to note if this is a repeated reaction.
Alcohol Contributes to Stress
Alcohol actually can contribute to long-term stress, as it often inhibits proper sleep cycle, and can exacerbate issues such as depression or anxiety. Thus, it will be leaned on cyclically as stress increases in the life of a functional alcoholic. It is not uncommon for people to drink to self medicate underlying mental health concerns and alcohol can make these symptoms worse.
Do YOu Avoid Confronting Your Spouse About His/Her Alcohol Abuse?
“Avoiding therapeutic confrontation ultimately creates more confrontation among those who choose the path of inaction.”
– Mike Loverde
The Myth of Functioning Alcoholism
The delusional part about functional alcoholism is the operative term of ‘functional’. There is truly no such thing as a functional alcoholic; there is only an alcoholic who has so far managed to avoid or hide the major consequences of their alcoholism. A “functional alcoholic” is often thought of as an alcoholic that is good at “keeping it together” and they haven’t experienced the “Yet’s”. They have not lost their job yet, they have not had a DUI yet, they have not experienced medical issues yet. A functional alcoholic is almost always an alcoholic or family who is comparing them to those that are worse off than they are. They don’t fit the stereotype.
Consequences of Functional Alcoholism
A person with an alcohol use disorder may be considered functioning because they have avoided the stereotypical rock bottom consequences like being arrested, being hopelessly in debt, or unable to hold a job; the “yet’s”. That does not mean the alcohol use is not negatively affecting them and their families. Depression, difficulty sleeping, anxiety/panic attacks, and anger or aggressive behavior issues can all be putting a functional alcoholic’s mental and physical health at risk. The risk of rock-bottom consequences are often looming closely, and the concern should be: how much longer can this growing problem be considered “functioning?” It is common for families to gauge the severity of an alcohol use disorder based on alcohol consumption. The alcoholic may be able to hide the alcohol and it is far more difficult to hide the behaviors.
Living with an Alcoholic
What could you expect from living with a functional alcoholic? A strong possibility for frequent ups and downs, not only in their moods, and also in their financial, emotional, and social states. A functional alcoholic will often try and control certain aspects of home-life to ensure that they can comfortably continue their drinking. It is very common for one or more in the household to become an enabler to the functioning alcohol abuser, whether they are cognizant of it or not.
In the early stages an alcoholic may want to set a party atmosphere or a very open environment in the house that supports their habit. A person using alcohol beyond moderation can come into conflict with anyone that impedes their drinking habits. It is important to consider that their drinking could eventually become the priority as it often does with a moderate or severe alcohol use disorder. Tasks such as paying bills, cleaning the house, or keeping relationships take a back seat. Understanding these risks can be helpful if you’re considering entering into a living situation or remaining in a living situation with an alcoholic.
Alcohol Use Disorder and Your Relationship
Living with an alcoholic can be overwhelming, especially for a spouse or significant other. When children are present in the home, it can and will take a toll on their mental health and emotions. Alcoholism often feels like a losing battle for those on the receiving end, and it tends to play out very slowly. The slow decline not only makes it harder to see, it allows those affected to make more justifications for themselves and the alcohol user. If things went from good to unmanageable in one fell swoop, it would be far more obvious and action would most likely be taken quickly. Those with an alcohol use disorder often find themselves with two choices: seek help or follow the chronic progression through until the end. A relationship with a functioning alcoholic can only be a “functioning relationship”. A relationship with problems surrounding alcohol may not be fully addressed until the alcohol user and those affected by it seek help.
Binge Drinking & Drinking More Than Once Per Week Should Not Be COnsidered Normal Drinking Habits
Due to how acceptable social and recreational drinking is, excessive alcohol use may be difficult to identify. This is why focusing on behaviors provides much better insight than does trying to watch for excessive consumption. Even binge drinking or alcohol warning signs may be missed or be perceived as moderate or tolerable.
The Diagnostic and Statistical Manual of Mental Disorders (DSM V) has 11 questions to help determine the severity of an alcohol use disorder. The classifications results are mild, moderate, and severe. The American Society of Addiction Medicine (ASAM) has 6 dimensions to help identify severity ratings. It may be difficult to self diagnose your loved one because of bias and an emotional attachment. Although an appropriate assessment would require the alcohol user to answer the questions, a family can read through them and see all that apply.
Contacting a professional interventionist or other addiction professionals could provide you with some insight and feedback to these questions. When you read through the questions of these assessment instruments you will see how interested they are in determining behavior as well as the effects of consumption. If their behaviors are leaning towards a problem then it is most likely these behaviors are affecting you and the families quality of life.
Dealing with An Alcoholic Roommate
To protect yourself from the alcoholic it is suggested that setting boundaries and holding them accountable for his or her actions is often helpful for both you and them. Although it is difficult to separate intellect from emotion when doing this, the alternative is allowing the alcoholic to take you down with them. This approach can help the alcoholic take ownership for their behaviors and can increase their ability to see the need for change. Alcohol intervention for a roommate that hopefully includes their family would be the next step in helping your friend address their alcohol problems.
Confronting an alcoholic that is not a family member can be less difficult because there may be less emotion and attachment. The responses from the alcoholic towards a non family member can be less reactive as well. This can be the result of lesser resentments towards family members who alcohol users often blame for their troubles. A family member is more likely to be emotionally attached and affected therefore turning the conversation down the wrong path without a professional present.
Families may have a more difficult time setting boundaries and holding them accountable too. Families are frequently more fearful of the confrontation because of guilt, shame and past experiences. If parents and family members assist along with the roommates, this can provide a wider range of awareness to the alcoholic. The alcoholic is more likely to see that non family members are affected too as a result of the alcohol abuse.
Alcohol Intervention for a Non-Family Member
In cases where you are helping intervene for a non-family member, the family members of the alcoholic can and should be involved with planning an intervention, treatment, aftercare, and ongoing support like alcohol support groups. If your friend’s family is not available or willing to help or acknowledge the addiction situation, it should not prevent you from setting boundaries, holding them accountable and protecting yourself. A family addiction interventionist can help in these situations by offering both a consultation that involves family, friends and roommates.
Seeking help for someone is equally as much about seeking help for yourself. Approaching it with professionals and an open mind can be beneficial for all those involved.
Interventions for a Non-Family Member? Contact Us >
What is the DSM 5 criteria for alcohol use disorder?
DSM V 11 Alcohol Use Disorder Questions
The criteria for alcohol use disorder, according to DSM-5, consists of the following 11 questions. The presences of at least 2 of these symptoms indicates Alcohol Use Disorder (AUD). The presence of 2-3 symptoms indicates a Mild AUD. The presence of 4-5 symptoms indicates Moderate AUD. The presence of 6 or more symptoms indicates Severe AUD.
In the past year, have you:
Had times when you ended up drinking more,
or longer, than you intended?
More than once wanted to cut down or stop
drinking, or tried to, but couldn’t?
Spent a lot of time drinking? Or being sick or
getting over other aftereffects?
Wanted a drink so badly you couldn’t think of
Found that drinking—or being sick from
drinking—often interfered with taking care of
your home or family? Or caused job troubles?
Or school problems?
Continued to drink even though it was causing
trouble with your family or friends?
Given up or cut back on activities that were
important or interesting to you, or gave you
pleasure, in order to drink?
More than once gotten into situations while or
after drinking that increased your chances of
getting hurt (such as driving, swimming, using
machinery, walking in a dangerous area, or
having unsafe sex)?
Continued to drink even though it was making
you feel depressed or anxious or adding to
another health problem? Or after having had a
Had to drink much more than you once did to
get the effect you want? Or found that your
usual number of drinks had much less effect
Found that when the effects of alcohol were
wearing off, you had withdrawal symptoms,
such as trouble sleeping, shakiness,
restlessness, nausea, sweating, a racing heart,
or a seizure? Or sensed things that were not
Helping Your Friend, Family Member, or Spouse Seek Alcohol Addiction Treatment
MENTAL STRESSORS & ANXIETIES THAT WILL WORSEN SUBSTANCE ABUSE ISSUES
Your spouse may not be willing to admit that they have a problem. There are times when they will admit there is a problem and be unwilling to pursue treatment for their addiction. The first and most difficult step in the long-term recovery process is for them to admit they have a problem. Anytime a substance user moves from precontemplation to contemplation stage is a victory. In simple terms, precontemplation is not being aware there is a problem and contemplation stage is being aware there is a problem.
An addiction interventionist can help a family identify things they are doing that may be holding the alcoholic in a precontemplation state. A professional addiction intervention can help the alcohol user take ownership for some of the problems they have been blaming others for. The more an alcoholic can see their part in the problem the more likely they are to surrender to alcohol addiction treatment. Blaming others allows the alcoholic to be a victim and their focus is to make everyone else to see what they did wrong and not themselves. This delusional thinking on the alcoholics part can prevent them from seeing the need to seek help for themselves. The more they think everyone else is the problem the less of a problem they have or need to address. Those with moderate to severe alcohol use disorders often try to fix, manage and control everybody and everything. If they can just make everyone else and everything else go the way they need it to, all will be well.
Treatment for Functional Alcoholism
Do Functional Alcoholics Need Rehab?
Residential Treatment for Alcoholism
It may be necessary to consider residential treatment where qualified professionals can stabilize and treat your spouse. Family First Interventionists perform a pre-intervention assessment to help determine level of care for the alcoholic. This process can help the family see the degree of severity their loved one is at. Some questions we ask may not seem relevant and they are intended to help determine how much help your loved one may require.
What happens after treatment is just as important. Aftercare and alcohol relapse prevention can help increase the opportunity for continued sobriety and abstinence. This should be discussed and planned with your interventionist.
Getting Help for a Functional Alcoholic
When faced with the challenges of living with a functional alcoholic spouse, we suggest seeking professional guidance. An emotionally connected family member is most likely to be flooded and lacks the ability to make proper judgement. It is best to let others who are not affected and who are experienced show you the way.
Family First Intervention recognizes how powerful the dynamic of a family system is and how important the role family members play in a substance user’s decision to accept treatment for addiction. We hope a family sees the need to seek professional guidance as much as the substance user requires professional guidance. We are privledged to be an integral part of your loved one’s decision to recover from functional alcoholism.
For any of these conditions, it is important to talk to a counselor, interventionist or therapist about your worries and to practice consistently healthy habits when you can create a baseline for your health.
What Will the Journey to Addiction Recovery Look Like for You and Your Family?
We believe the results will be worth the journey, so we hope you embark on it.
More Resources for Spouses & Families of Alcoholics