Alcoholism is no joke, but it can be more difficult than you think to determine when you have crossed the line from “party animal” to a “problem drinker”. Those with HFA (High Functioning Alcoholic/Alcoholism) have an innate ability to hide in “plain sight” and this has quickly become the new buzzword for heavy drinkers. Here is a quick guide to let you know if you are an HFA and determine if you may need help.
What is Alcoholism?
“Alcoholism” is a level of malfunction that is included in the overarching diagnosis of Alcohol Use Disorder (AUD). The Mayo Clinic defines AUD as “a pattern of alcohol use that involves problems controlling drinking, being preoccupied with alcohol and continuing to use alcohol even when it causes problems.”
Most experts believe that “alcoholism” or AUD is on a spectrum which means that there are different phases of addiction that you may experience during your life. This is supported by the Diagnostic Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which asserts that AUD has 3 diagnostic levels which include ‘Mild, Moderate and Severe’. If you have at least 2 symptoms from the list, then your AUD diagnosis will be ‘Mild’, 4-5 symptoms is ‘Moderate’ and 6+ is ‘Severe’. The simple truth is that most addicts oscillate between these different stages of addiction depending on their particular circumstances and stressors.
What exactly is an HFA?
Most people with HFA know on some level that they have a problem with drinking. However; they may still be in denial about their ability to “control” their addiction, or refuse to take any responsibility for the harmful effects their drinking has on friends and family. Many HFA’s go to work every day, own their own homes, raise children, volunteer for their communities and appear to be happy and successful individuals. This is usually a falsehood rooted in hypocrisy.
According to the National Institutes of Health (NIH), there are 5 alcoholism subtypes. HFA is one of the functional subtypes which accounts for 19.5 % of all alcoholics in the United States. Many HFA’s are not lifelong drinkers and it often develops in middle age.
Only ¼ of people with functional alcoholism suffered from problem drinking behaviors in the past, with another ¼ suffering from mental health issues such as anxiety and/or depression. Functional alcoholics don’t usually skip work, or miss family events and social events, but they may display other symptoms that fit the criteria for AUD such as:
- Changes in attitude or mood
- Loss of focus or memory
- Cognitive decline
- Shakiness or tremors due to alcohol withdrawal between drinks
- Paranoia or anxiety
- Other physical health declines
- Missing deadlines at work or school
- Calling in sick or skipping social events more and more often
- Drinking at work, school, or other times when it is not appropriate or acceptable
Sobering Facts about AUD
A recent article by Psychology Today stated the (AUD) is an “untreated epidemic” in the United States with only 5.2% of adults seeking treatment each year. In a study conducted by World Health Organization (WHO) in 2018, it was found that alcohol consumption is directly related to up to 3 million deaths annually, accounting for 5% of the global disease burden.
AUD is most prevalent in wealthier countries with Europe and America topping the list. An estimated 237 million men and 46 million women suffer from alcohol-related issues in Europe where AUD affects 14.8% of men and 3.5% of women. In the USA, 11.5% of men and 5.1% of women suffering from AUD.
A study published in April 2015 reported that binge drinking in the United States is escalating. In The United States, binge drinking by women increased more than seven times the rate of men.
On average, heavy drinking among Americans rose 17.2 percent between 2005 and 2012. It also found a “lifetime AUD prevalence” of 29.1% and a 12-month prevalence of 13.9% which represents more than 68.5 million Americans.
This is echoed by a global study that tracked 195 countries published in The Lancet in 2018. It reported that British women are the world’s biggest drinkers and distinguish themselves by uniquely having no difference in the amount of alcohol men and women consume.
The global statistics for AUD are both shocking and staggering. Not everyone who is diagnosed with AUD alcohol exhibits the same signs or symptoms and some people are better at hiding or managing their symptoms. Psychology Today studies reveal 68.5 million Americans will experience alcohol use disorders at some point in their lifetime.
Many of these are HFA’s who manage to go about their daily lives while maintaining the appearance of a normal life. Statistically, they are the least likely to seek help and will often suffer in silence for years.
Spotting the Warning Signs
If you are concerned about your drinking habits or want to get some information that you can share with a friend or loved one about their drinking habits, then be sure to read the following checklist. These are the top 6 warning signs that you may be an HFA.
Need to Drink in Every Social Situation
Social drinking turns to problem drinking when you find yourself needing a drink for nearly every situation. You may feel the need for a drink to calm down, to perk up, to go to sleep, or even to wake up. You may also find yourself not attending events where there is no alcohol available, and find yourself socializing with other people who enjoy drinking as a mandatory part of spending time together.
Drink On Your Own
The title says everything you need to know. If you’re drinking alone, then social drinking has moved past the stage of “drinking socially”. Another major sign of a high-functioning alcoholic is when you’re drinking in secret or hiding how much you consume.
Can’t Stop Once You Start
There is a poignant quote by Pulitzer prizewinning author F. Scott Fitzgerald where he proclaims “First you take a drink, then the drink takes a drink, and then the drink takes you”. Many HFA’s report that they do not have an “off” button once they start drinking and have a problem stopping once they start. No alcohol is ever wasted and you may even finish other people’s drinks. There is always an excuse for “just one more” and you will often lose track of time as well as how much alcohol you consumed.
Getting Drunk is the Goal
Many HFA’s go out to “get pissed” or get “messed up”. Binge drinking is commonplace, and you will find yourself having a drink or two before you go out, or just before guests arrive if you are hosting a party. Others replace meals with a few drinks or lose interest in food altogether when you are drinking.
Few Hangovers & Side Effects
Another sign is drinking large quantities of alcohol without getting sick or appearing outwardly inebriated. Drinking alcohol regularly over a long period of time can cause the body to become dependent on alcohol and make your tolerance exceptionally high. You may find yourself being able to drink a lot more without suffering from a major hangover like those other “lightweights” who can’t hold their liquor. While this may on the surface seem like it’s a benefit, it’s actually a major sign that you are an HFA.
Admit or Joke About Alcoholism
Many HFA’s seem to take pride in their heavy drinking prowess and their ability to “drink you under the table”. They may make jokes about their drinking habits or make fun of others. If you find that you are comparing your drinking with others, or telling people that you know you need to stop drinking so much, then you should find out what options are available. People without drinking problems don’t worry about their drinking, just like people without diabetes don’t worry about their blood sugar.
Although indeed, some HFA’s will never experience major problems because of their drinking, they will also never be able to live their life authentically until they deal with their addiction.
Being an alcoholic still carries a certain stigma and many people who struggle with AUD hesitate to get help because of shame and fear of judgment. Other high-functioning alcoholics don’t get the help they need because they do not fit stereotypes about AUD. Yet the truth is most people don’t remain highly-functional forever. If you would like more information about addiction or a free assessment by a counselor to then please contact the professionals at The River Rehab to explore what treatment options are available.