Most of us are familiar with the concept of the “high-functioning” (or just “functioning”) alcoholic — a person who, contrary to popular stereotypes about addicts, manages to hold down a job, pay their rent, and otherwise maintain the appearance of a life untouched by addiction issues. But real information about high-functioning alcoholics — and how to know if you or someone you love may be one — is in relatively short supply. Sarah Allan Benton, in Understanding The High-Functioning Alcoholic, explains that many of our contemporary understandings and definitions of alcoholism and addiction leave room for high-functioning alcoholics to “slip through the cracks,” in part because of a comparative lack of scientific studies specifically focused on functioning alcoholics in particular. But understanding how this type of addiction functions is important — because high-functioning alcoholism can be just as damaging to the addict and their loved ones as very clear and obvious alcoholism.
In the most basic sense, a functioning alcoholic is one that, according to the definition of the rehab center Gateways, “can hold down a job, pursue a career or care for children while continuing with his or her alcoholism;” a high-functioning alcoholic does these things with extreme success and no apparent impairment. In these contexts, diagnosing the alcoholism itself can be exceedingly difficult, particularly for outsiders. However, the questionnaire for Alcohol Abuse Disorder found in the DSM-V, the diagnostic publication of the American Psychiatric Association, shows that people can fit the measures of a severe drinking disorder — inability to quit drinking, tendency to put themselves in situations where they may get hurt, experiences with withdrawal — while still appearing outwardly like perfectly healthy beings with functional lives. And that makes for a very dangerous combination — not just because it may discourage loved ones from urging the alcoholic to seek treatment, but because it may keep anyone from recognizing that a problem even exists.