Alcoholism can present itself in several different ways; both high-functioning alcoholism and dysfunctional alcoholism carry significant risks to the person involved and may require treatment from addiction professionals to recover.
Understanding the differences between high-functioning alcoholism and dysfunctional alcoholism can help you identify when alcohol use is causing problems and get the support you need to thrive.
What Is High-Functioning Alcoholism?
High-functioning alcoholism refers to a condition in which a person manages to maintain their social, occupational, and financial obligations despite being unable to control their drinking.
People with alcohol dependence alone experience severe physical and psychological effects. However, they generally don’t experience the typical social, occupational, and legal consequences associated with alcoholism.
Typically, people with high-functioning alcoholism deal primarily with the physical effects of an alcohol use disorder, such as:
- Tolerance to alcohol
- Intense physical withdrawal symptoms if alcohol use suddenly stopped
- Drinking frequently and in high amounts
- An inability to cut down or stop drinking on their own
- Continuing to drink despite harmful consequences
- Spending a great deal of time drinking, seeking alcohol, or recovering from its effects
Diagnosing High-Functioning Alcoholism
In previous years, the American Psychiatric Association’s Diagnostic and Statistical Manual IV (DSM-IV) had a specific categorization for high-functioning alcoholism. People who struggled with alcohol use fell into two distinct categories:
- Those experiencing alcohol abuse
- Those experiencing alcohol dependence
However, if people experienced symptoms of both alcohol abuse and alcohol dependence, they would be classified as just having alcohol dependence, so high-functioning alcoholism automatically fell into the dependence category.
But the fifth edition of the Diagnostic and Statistical Manual combined the distinction of alcohol abuse and dependence into the same category: alcohol use disorder (AUD). Based on the number of criteria met, the diagnosis would come with a mild, moderate, or severe sub-classification.
Many people fall prey to the belief that so long as they keep their jobs, fulfill their obligations, and don’t suffer legal consequences for their drinking, they don’t truly have an alcohol problem, but this couldn’t be further from the truth. High-functioning alcoholism can lead to devastating consequences down the line.
Dangers of High-Functioning Alcoholism
Since high-functioning alcoholics can continue to work and maintain their personal responsibilities, they may never experience a “wake-up call” to stop drinking; they can continue drinking in high amounts for years or even decades.
Heavy drinking for extended periods can have severe physical consequences, though people may not begin to show symptoms until they experience permanent damage. A few of the potential consequences include:
- Severe liver damage
- Increased risk of mouth, throat, liver, colon, and breast cancer
- High blood pressure
- Heart failure
Worse still, by the time these health problems develop, people with high-functioning alcoholism may have an incredibly difficult time cutting down or stopping their alcohol use. Their brains and bodies have become accustomed to the influence of alcohol, which creates dangerous physical and psychological withdrawal effects after reduced alcohol intake.
People who have lived with high-functioning alcoholism for extended periods often experience severe withdrawal symptoms when they attempt to quit. Alcohol withdrawal happens when the central nervous system has become accustomed to the effects of drinking.
Alcohol is a central nervous system depressant – it slows down life-preserving functions, such as breathing and heart rate. Over time, the central nervous system compensates for this effect, becoming more active in its natural state.
When someone with alcohol use disorder stops drinking, their central nervous system becomes dangerously overactive, and they can experience withdrawal effects such as:
- Racing heart rate
- Nausea or vomiting
In severe cases, people may experience a set of symptoms known as delirium tremens, which is the most severe form of alcohol withdrawal and includes symptoms such as:
The seizures from alcohol withdrawal can be fatal, but professional medical detoxification can reduce the risk of seizures and other withdrawal symptoms. A professional level of support is essential when people with alcohol use disorders quit after extended use.
Lastly, high-functioning alcoholics can often develop a serious brain disorder called Wernicke-Korsakoff syndrome, also known as wet brain. Wet brain is caused by vitamin B1 deficiency and is frequently seen as a complication in long-term heavy drinking.
People who experience significant social, occupational, and legal consequences due to drinking are said to have dysfunctional alcoholism. In previous years, dysfunctional alcoholism was diagnosed as alcohol abuse.
Dysfunctional alcoholism overlaps with the same physical consequences of drinking as high-functioning alcoholism. However, people with dysfunctional alcoholism also experience interference with their ability to maintain some or all of the functions of daily life.
People with dysfunctional alcoholism primarily struggle with the following:
- An inability to stop drinking on their own
- Repeated social or interpersonal problems as a result of their alcohol use
- Using alcohol when it is dangerous to do so
- Alcohol use interferes with obligations at school, work, and home
Signs and Symptoms of Dysfunctional Alcoholism
The signs and symptoms of dysfunctional alcoholism are often more apparent to an outside observer. People with dysfunctional alcoholism can show signs such as:
- Isolating themselves from others
- Job loss due to alcohol use
- Changing their social groups
- Failing to keep up with responsibilities
- Abandoning hobbies and activities that used to be important to them in favor of alcohol use
- Physical withdrawal symptoms if alcohol use suddenly stops
The primary criteria for diagnosing a person with an alcohol use disorder is an inability to stop drinking despite harmful consequences. People with dysfunctional alcoholism often experience a host of consequences, including significant personal and financial hardship due to alcohol use.
Dangers of Dysfunctional Alcoholism
The dangers of dysfunctional alcoholism are troubling at best. People who live with an alcohol use disorder not only face severe physical health consequences, but may also sabotage important life goals and achievements in favor of alcohol use. If left untreated, people with dysfunctional alcoholism may lose their jobs, homes, relationships, and security.
Furthermore, dysfunctional alcoholism can trigger the same dire set of health-related consequences as those with high-functioning alcoholism. They can experience the same physical withdrawal effects, increased risk of cancer, and irreparable damage to the liver. People with an alcohol use disorder often cannot stop drinking independently and may need addiction treatment to recover.
Treating Alcohol Use Disorders
The methods for treating high-functioning alcoholism and dysfunctional alcoholism are typically the same. A professional addiction treatment center uses several evidence-based treatments and therapies to help people overcome their cravings for alcohol and learn healthy coping mechanisms to use in recovery.
Recovery typically happens in a multi-stage process that includes medical detox, residential treatment, outpatient treatment, and support groups.
Medical detox is the first step in an addiction continuum of care. Professional detox centers treat the physical withdrawal symptoms of alcohol use disorders. Using specialized techniques, addiction professionals can make alcohol withdrawal safe, more comfortable, and conquerable.
Residential treatment provides intensive therapies designed to help people overcome the psychological components of alcohol use disorders. Residential treatment serves as a recovery incubator, teaching people the skills needed for long-lasting recovery.
At All Points North, we offer deep TMS, hyperbaric oxygen therapy, family therapy, and relaxation techniques like yoga, breathwork, and meditation to complement the hard work clients do in individual and group therapy and deepen recovery-focused attitudes and behaviors.
Treatment centers are a safe space for clients to get to the root of addiction issues, address any co-occurring disorders, and lay the foundation for life in recovery.
Outpatient programming can help people with alcohol use disorder put their new skills into practice and continue learning new methods to stay sober.
Although outpatient programming offers more freedom and a lower level of acuity, people in recovery can stay immersed in a support network with continued accountability while they transition back to their everyday lives.
Clients in an outpatient program can participate in person at a residential treatment center or virtually with online meetings. As new obstacles arise, they can lean into support from a therapist and their peers and deepen their self-confidence in navigating sobriety outside of a more structured treatment environment.
Support groups play a vital role in building social support for recovery. Groups such as Alcoholics Anonymous, SMART Recovery, Women for Sobriety, Celebrate Recovery, and alum programs associated with specific treatment centers allow people in recovery to support each other with their shared goal of sustained sobriety.
Everyone needs a support network, and having a designated group committed to recovery can increase the likelihood of sustained sobriety. Support groups often host in-person and virtual events to help people learn how to have sober fun.
Professional Support for Alcohol Use Disorder
Everyone deserves help in their darkest moments. Whether you’re struggling with high-functioning alcoholism or dysfunctional alcoholism, recovery is possible, and evidence-based treatment can help pave the way on your journey to sobriety.
If you’d like to learn more about how All Points North uses a comprehensive approach to help people recover from alcohol use disorders, reach out to our team using the live chat function, fill out our confidential online form, or call 855.235.9792.
- “Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration, June 2016.
- Saitz, R. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World vol. 22,1 (1998): 5-12.