Understanding the high-functioning alcoholic

If the word alcoholic has you picturing a bum falling down in the street or that -œloser- chick you knew in college that could outdrink the frat boys, you might be surprised to know that there are successful people – the minister of your local church, your uncle who is a decorated general, your best-friend mompreneur – who are also alcoholics. And despite their external achievements, they are still suffering from a disease – alcoholism. Do you know a high-functioning alcoholic (HFA)? Keep reading to learn more about this often ignored condition.

What is a high-functioning alcoholic (HFA)?

According to Boston-based licensed mental health counselor Sarah Allen Benton, recovering alcoholic and author of Understanding The High-Functioning Alcoholic: Professional Views and Personal Insights, being successful professionally or personally and being an alcoholic are not mutually exclusive.”A high-functioning alcoholic (HFA) is an alcoholic who is able to maintain his or her outside life, such as a job, home, family and friendships, all while drinking alcoholically,” explains Benton, who is also the addiction blogger for PsychologyToday.com. “HFAs have the same disease as the stereotypical ‘skid-row’ alcoholic, but it manifests or progresses differently.”

The problem is denial

The danger with HFAs is that not only does society overlook their excessive drinking (after all, HFA’s seem to have it all together), but, to compound the problem, HFAs also remain in denial because they don’t think they are the stereotypical low-life drunk.

“Many HFAs are not viewed by society as being alcoholic, because they have succeeded and overachieved throughout their lifetimes,” explains Benton. “These achievements often lead to an increase in personal denial as well as denial by colleagues and loved ones. HFAs differ from lower-functioning alcoholics in the way that they appear to the outside world. They are able to hide their addiction so that loved ones and colleagues often do not think or realize that they are alcoholic.”

Overachievers may be prone to being HFAs

Benton says research suggests that HFAs tend to gravitate toward certain professions, particularly business, law and health care. (Keep in mind, however, alcoholism doesn’t discriminate, and that both men and women can be HFAs and that all professions have HFAs.)

A study in the International Journal of Law and Psychiatry found that problem drinking had developed in 18 percent of the lawyers who had practiced for 2 to 20 years and in 25 percent of lawyers who had practiced for 20 years or longer. Benton adds, “The American Bar Association has found that lawyers and judges are overachievers who often take on excessive amounts of work and tend to escape from these stressors through alcohol and drugs.”

According to Benton, interviews with addiction experts indicate that drinking cultures in business and law graduate schools contribute to higher alcoholism rates in these professions. Additionally, statistics from the Massachusetts Committee on Drug and Alcohol Dependence, suggest that 8 to 13 percent of health care professionals have alcohol or drug dependence, which is a higher rate than that of the general population.

Criteria for high-functioning alcoholics

Do you suspect someone you know — maybe even you — is an HFA? Through her interviews with sober HFAs, Benton created the following list of characteristics that HFAs display. These include but are not limited to:

Drinking patterns:

• When they have one drink, they experience a craving to have more and cannot predict what their alcohol intake will be.
• They obsesses about the next time they will be able to drink alcohol.
• They behave in ways that are not characteristic of themselves while drunk and continue to repeat these unwanted behaviors and patterns.

Denial:

• They have difficulty viewing themselves as alcoholics because they don’t fit the stereotypical image and because they feel their lives are manageable.
• They avoid recovery help.
• They make excuses for drinking by using alcohol as a reward or to relieve stress.

Professional and personal life:

• They are well respected for job/academic performance and accomplishments.
• They can maintain a social life and intimate relationships.
• They surround themselves with people who drink heavily.

A double life:

• They appear to the outside world to be managing life well.
• They are skilled at living a compartmentalized life (ie, separating professional, personal, and drinking lives).

Hitting bottom:

• They experience few tangible losses and consequences from their drinking, often by sheer luck.
• They experience recurrent thoughts that because they have not “lost everything,” they have not hit bottom often hit bottom and are unable to recognize it.

HFAs are leading a destructive life

Even though HFAs seem to have it all together, their excessive drinking can put their health — and even life — at risk. Despite the façade of success, HFAs have the disease of alcoholism — a disease that is lifelong, chronic, progressive, and potentially fatal. “While HFAs may be succeeding professionally or academically, they may be engaging in dangerous behaviors, such as drinking and driving, having risky sexual encounters, blacking out (memory lapse), etc,” warns Benton. “Although they may have been able to avoid serious trouble professionally or personally to a certain point, it is only a matter of time before alcoholism will lead to problems.”

Learn more

April is Alcohol Awareness Month. If you suspect you or a loved one is an HFA take advantage of your local resources to learn more about this disease and options for recovery. You can also visit Benton’s website HighFunctioningAlcoholic.com or pick up her book Understanding the High-Functioning Alcoholic.

Benton concludes, “HFAs are putting not only their own health at risk through their alcoholic drinking, but also the emotional health of their families because they are not getting treatment for their alcoholism.”

Keep reading for more on alcoholism

Signs that you are — or are not — an alcholic
The hidden epidemic of very young alcoholics
Pregnant and still drinking