While the caricature of an alcoholic might resemble a cartoonish version of a bumbling drunk, in reality, many who battle this serious addiction manage to remain under the radar.
A high functioning alcoholic is quite adept at masking the smells or signs of alcohol and often goes to great lengths to hide it. The truth is, however, even if someone is very skilled at hiding their dependence on alcohol, many who are successful at deflecting attention from the drinking problem are doing so at their own peril. The longer that undetected alcoholism is allowed to fester and intensify, the harder it is to overcome the insidious disease.
Learning to recognize the signs, both obvious and subtle, can lead to earlier intervention and a better recovery outcome. While no one wants to admit that they have a problem with alcohol, just addressing it with them calmly may lead to a deeper conversation that results in them seeking treatment.
Alcohol Abuse Precedes Alcoholism
Alcoholism starts off as alcohol abuse. This refers to the excessive drinking that can precede the development of a chemical dependence on alcohol. Recognizing those warning signs can hopefully lead someone who is abusing alcohol to change their behaviors before addiction and dependence set in. Signs of alcohol abuse include:
- Experiencing blackouts or short-term memory loss due to excessive drinking
- Prioritizing drinking, putting drinking above work, relationships, and obligations
- Mood swings
- Irritability
- Drinking alone
- Hiding alcohol, lying about how much you are drinking
- Isolating behaviors, withdrawing from family
- Using alcohol to self-medicate, to reduce stress, anxiety, depression
- Neglect personal hygiene
- Change in physical appearance, bloating, weight gain, ruddy complexion
- Hanging out with drinking buddies more and more
What Are the Signs of Alcoholism?
The signs and symptoms of alcoholism include behavioral, physical, and psychological elements. Alcohol use disorder (AUD) is diagnosed by a list of criteria determined by the DSM-5. The more symptoms present, the higher the severity of the AUD. Mild AUD involves 2-3 criteria, moderate AUD is indicated when 4-5 criteria are met, and severe AUD is when 6 or more criteria are met.
The diagnostic criteria include:
- Alcohol used in larger amounts or over a longer period of time than intended
- Persistent desire or unsuccessful attempts to cut down or control alcohol use
- Significant time spent obtaining, using, and recovering from the effects of alcohol.
- Cravings for alcohol
- Recurrent alcohol use leads to failure to fulfill major role obligations at work, school, or home
- Recurrent use of alcohol, despite having persistent or recurring social or interpersonal problems caused or worsened by alcohol
- Giving up or missing important social, occupational, or recreational activities due to alcohol use
- Recurrent alcohol use in high-risk situations
- Increased tolerance markedly increases levels of alcohol consumption to get the desired effect
- Experience withdrawal symptoms when alcohol is withheld
How Does Someone Become Alcoholic?
Alcohol is a depressant that works on the central nervous system, slowing the functioning and activity of nerve cells. The relaxing properties of alcohol can be attractive to someone who might be struggling with symptoms of depression or anxiety. Someone with social anxiety may have a couple of drinks to muster courage before attending a social event. Individuals in high-stress jobs may lean on alcohol to quiet nerves and decompress. In summary, there are many ways that alcohol can be used as a method of self-medication.
Alcoholism evolves pretty much under the radar. It tends to sneak up on someone, usually due to increasing tolerance. As tolerance to the effects of alcohol increases, so does alcohol consumption. Over time, it takes more and more alcohol to achieve the desired effects. Meanwhile, the brain's neurotransmitters begin to adjust in response to the consistent influx of alcohol, changing the neural pathways and etching alcohol dependence into the brain's reward system. Then one day you wake up to find your hands trembling. Or maybe you wake up feeling nauseous. Possibly you crave alcohol from the time you get out of bed. These are the signs of alcoholism.
The Link Between Stress and Alcoholism
The link between stress and alcohol abuse was clarified in a research study of the connection back in 1943. The study identified what was referred to as the tension-reduction hypothesis, the tendency to reach for alcohol to reduce the anxiety effects caused by a stressful situation. Recent studies have further specified the different types of stressors and how genetic factors and life experiences can influence how we respond to them.
It isn't hard to understand the connection between stress and alcohol abuse. Alcohol has long acted as a coping tool for managing stress. Those in high-stress positions are prone to developing an alcohol use disorder, unsurprisingly. In fact, according to an article from the National Institute of Alcohol Abuse and Alcoholism, it notes that researchers found that both men and women who reported higher levels of stress tended to drink more, with men having a 2.5 times higher rate of an AUD.
What Are the Treatment Options for Alcoholism?
Treatment for AUD is available in both outpatient and residential formats. Generally, outpatient programs are better suited for individuals with a mild to moderate AUD, and the residential setting more appropriate for moderate to severe AUD. Programs come with many diverse philosophies and services, ranging from basic to luxury. There are pet friendly rehabs, faith-based rehabs, couples rehabs, resort-style rehabs, and many other varieties available.
Treating an alcohol use disorder will encompass a multi-pronged approach, with psychotherapy as the foundational treatment element. Evidence-based therapies, such as cognitive behavioral therapy (CBT), contingency management (CM), and dialectical behavioral therapy (DBT), are offered in both individual and group therapy formats. These behavior-based therapies provide the individual with the methods and motivations to change reflexive addict behaviors, shifting to more positive, productive behaviors by identifying triggers and using new coping skills.
Treatment programs are rounded out with various other treatment elements, including medication management (naltrexone), education and relapse prevention, 12-step programming, and holistic therapies. Together, this integrative approach can help someone with an AUD carve out a new life for themselves in recovery.
