Living With a High-Functioning Alcoholic Spouse: Early Signs and What to do?

High-functioning alcoholics are an incredibly difficult subset of alcohol addiction to identify and address. It may take their spouses and loved ones years of observation before they make the connection. For them, it starts as a sneaking suspicion that grows as they notice alcohol use becomes more frequent.

Other spouses can identify their loved one as a high-functioning alcoholic but see little hope in being able to help them get free. While it can be a disheartening situation, there are some strategies and approaches that may help in guiding them towards receiving help. Let’s take a look at what high-functioning alcoholism is, how to identify it and what steps you can take in helping your spouse or loved one start the journey towards getting free from addiction.

Defining high-functioning alcoholism

It’s important to remove the stereotypical view many of us hold regarding alcoholics. For many, it pictures someone who constantly drinks, experiences daily hangovers, and often can’t recall what happened the night before. They envision someone who can’t get their drinking under control even though their family is falling into chaos.

Regarding alcoholism, also referred to as alcohol use disorder (AUD), various subsets fall on a spectrum. High-functioning alcoholism can be difficult to identify. Those who suffer from this kind are adept at hiding traditional symptoms of alcohol use disorder. When someone is a “high-functioning alcoholic,” they may be able to carry out daily living tasks such as holding a job, hygiene, paying bills, and socializing without displaying common clinical identifiers associated with alcohol use disorders (AUD).

However, regardless of what it looks like on the outside, the root is still the same as other forms of alcohol use disorder, a chronic disease characterized by uncontrolled drinking. They can’t control drinking due to physical and emotional dependence on alcohol.

The dangers of high-functioning alcoholism

As with any other form of AUD, the results of this kind of addiction will eventually lead to dire consequences. Many loved ones will remark on how they do all the right things, but somehow something is just missing. Their ability to “be present” often comes into question, and they begin to form an emotional distance from those that do not share in their addiction in a way that can put them further from the people that can help them.

Alcoholism wreaks havoc on multiple levels, including physical health. Based on numerous peer-reviewed studies, prolonged excessive alcohol use has been linked to things such as fatty liver disease, liver fibrosis, increased risk of cancer death, a weakened immune system, and pancreatitis.

Left untreated, high-functioning alcoholics will eventually find themselves experiencing a cascading series of negative mental, emotional and physical consequences. Unfortunately, their loved ones pay the greatest price in most cases.

Identifying a high-functioning alcoholic

Although they may be harder to discern from more exaggerated forms of AUD, there are still some ways to identify them in loved ones.

Identify patterns of heavy drinking

While it may seem obvious, many spouses aren’t normally aware of the sheer amount of alcohol their loved one consumes in a week. High-functioning alcoholics tend to be very sophisticated in how they spread out their drinking to make it seem less than it is.

According to the National Institute on Alcohol Abuse and Alcoholism, heavy drinking for men is defined as anything more than four drinks on any day and fourteen drinks within a week. For women, the number is three drinks on any day or more than seven drinks within a week.

An easy way to keep track is to keep a log of it on something like the notes app on your phone, for example. For one week, simply mark down every time your loved one consumes alcohol. It might be hard if they do a lot of recreational drinking apart from you, but a casual query or survey should help give you a general idea of what those numbers look like.

Pay attention to language and physical symptoms

It may be subtle, but you can spot those that suffer from an alcohol use disorder based on their humor, language, and word choices. They tend to make more frequent alcohol-related jokes or try to disarm others’ observations regarding their increased drinking with humor.

Does your significant loved one continually downplay their alcohol consumption? Do they often cite their high tolerance or ability to “hold their liquor”? Or do they play a form of verbal gymnastics to make you seem unreasonable for even asking them about it?

High-functioning alcoholics will repeatedly point to their ability to carry out their normal responsibilities and ability to justify why their drinking is not a problem.

Regarding physical symptoms, slurred speech and bloodshot or watery eyes are telltale signs of alcohol abuse. You may also observe unsteady walking, physical impairment, or difficulty with hand-eye coordination. Extremely important is to pay attention to their ability to navigate a car if they happen to be behind the wheel.

Take note of their actions

When asked where they would like to eat or spend time, pay attention to how insistent they are that the setting has alcohol available.

Does your loved one mention they will take it easy but end up going way past their limit and even binging? Are they choosing to drink early in the day or drink away from other people and social environments? Take note of what happens when they come under stress or lack confidence. Do they reach for a drink to help build themselves up?

Disciplinary actions or trouble with the law

Regardless of how high-functioning someone is under the influence of alcohol, it will eventually result in a breakdown in their professional lives and usually when it comes to the law. It’s important to note any problems they are having at work if there are reductions in pay or disciplinary measures. Being pulled over while intoxicated by a police officer should be a major red flag.

Why high-functioning alcoholism can be extremely dangerous

As mentioned earlier, this form of alcohol abuse will have far-reaching, multifaceted consequences. They are at risk of drinking and driving, being unsafe or using poor judgment with others, and even blacking out, all of which can be fatal.

Based on what has been shared, you may now be confident that your spouse is a high-functioning alcoholic. It can be a very discouraging reality. To make things worse, you may feel getting them to seek help is an impossible task. The good news is that there are some helpful strategies and support systems you can utilize to better your chances of helping your spouse seek the help they need. We’ll look at some of those strategies and then go over some of the best treatment options for your spouse to experience lasting freedom.

Gauge your level of communication

One of the first things to fall apart is communication. For many, isolation and disconnectedness are a byproduct of increased alcohol dependence. One of the first steps is determining where your lines of communication stand with your spouse. Productively addressing their addiction will require a great amount of rapport and trust. Taking efforts to repair any rifts or deficiencies in the area of communication will go a long way to helping your spouse be receptive to treatment. It’s easier said than done, considering that they are often the primary cause of the communication breakdown, to begin with.

Lead from a place of compassion and empathy

While it is one of the hardest things to do as a spouse of a high-functioning alcoholic, it can be the most important. Although harsh words and condemnation are likely justified given their behavior, it is the choice to instead lead with compassion and lean in with empathy that can help build a level of trust that may allow you to influence them towards seeking help when it’s time.

Taking this approach even when confronting or facing them with the harm their alcoholism is doing to you and your loved ones is one that can yield the greatest chance of success.

Seek supportive communities

You don’t have to walk this journey alone. Many spouses feel hesitant about confiding in their friends and family members for fear of how their husband or wife may be perceived. Thankfully, there are support groups available both in-person and online, where you can freely share your challenges and struggles with a caring community that understands what you are going through. These support groups can be an invaluable resource during this process.

Group counseling, people sitting in a circle, having a conversation
doctor explaining the chart to the patient

Recruit professional help

Suppose you are not seeing much progress after trying to address the situation independently. In that case, it may be time to consider bringing a professional into the conversation to help facilitate meaningful dialogue. Many couples will seek the help of a therapist or couples counselor to help provide an objective voice.

Consider an intervention

Although they may not think so, there tend to be many people in high-functioning alcoholics’ life that have noticed signs of their alcohol use disorder. If your spouse is especially handy at eluding confrontation, it may be helpful to facilitate an intervention that includes significant people from various facets of their life. There are many great resources on how to lead a successful intervention. The most important piece of advice is to have your spouse’s treatment options ready to be laid out and committed to.

It’s worth pointing out that, based on many studies, it’s important to utilize professional help for the detox and maintenance portion of your spouse’s journey. The guidance of a professional can help reduce the risk of relapse significantly.

With that in mind, let’s consider what professional treatment options are available once your spouse is ready.

Residential treatment programs

Depending on the severity of your spouse’s alcohol dependence, a round-the-clock, immersive detox program that residential treatment provides may be needed.

Health complications from a rough detox may require medical intervention, which this sort of treatment would be able to provide. In addition to that, residents can utilize counseling and receive resources to better prepare them for long-term freedom.

Outpatient treatment programs

It may not be feasible for your spouse to completely detach from everyday life. Outpatient treatment may be a good option for those that would like a professionally overseen detox program while still being plugged in. For example, a partial hospitalization plan (PHP) will provide high-level patient care, as you would see in an in-patient program, but your spouse would be able to live at home.

The benefits of an in-home detox program

While other options are effective, a growing number of clients are seeing the benefits of in-home alcohol detox treatment. Put simply; it is taking the best of both residential and outpatient programs and placing them in the comfort of your own home.

An in-home treatment program allows your experience to be customized to your spouse’s specific needs and the severity of the addiction. All state-of-the-art components for treatment are available within the comfort of your home, and medical attention is on hand as needed.

After a preliminary evaluation, your spouse will undergo an in-home alcohol detox, transitioning into a customized rehabilitation plan to ensure long-term success.

Besides the convenience, in-home detox programs are the most discreet and private of all the options. When speaking to your spouse about treatment, this privacy component could be a major selling point that could mean the difference between them saying yes or knowing.

As you can see, there are several options when it comes to treatment. Feel free to contact us with any questions if you feel an in-home treatment option may be worth considering.

Alcohol Dependency Taking A Toll On Your Life? Elite Home Detox Can Help!

If you are having difficulty reducing your alcohol intake, consider reaching out to Elite Home Detox. We work with you to build a custom plan towards sobriety, rather than the “one-size-fits-all” plans found in most clinic environments.

We offer medically-managed detox, counseling services for you and your family, aftercare case management, and recovery-focused medical services all in the comfort of your home. If you believe a loved one needs help with alcohol dependency, our Intervention specialists can help you and the rest of your loved one’s support network to motivate your loved one to accept help.

We know you probably have a lot of questions, and we’re ready to answer them. Call or click the button below to make an appointment today!


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