‘Am I a high-functioning addict?’ How to spot the signs in yourself and loved ones

12th July 2021
 minute read

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Not all addiction is obvious — on the surface, high-functioning individuals can often seem as if they have it all together. Here are some key signs of this type of addiction...

The respected doctor who illegally prescribes herself painkillers.

The flawless homemaker who drinks a bottle of wine while the kids are asleep.

The successful executive who can’t stop watching pornography in his office.

These individuals all have one thing in common — they are in the grip of a painful addiction. Yet if you met them in a professional or social setting, you might never even guess. They could seem polished, articulate and successful, yet behind closed doors, could be hiding a deep and devastating compulsion that is ruling their lives.

The fact is that many people with an addiction (around 20%, by some estimates) just don’t fit the stereotype of how they are supposed to look, live or behave. If you think that you yourself might be a ‘high-functioning addict’, then one sign is that you are able to project an image of stability, could have an impressive list of achievements and might even seem to ‘have it all’. You could also be well groomed, have lots of interests and be great company socially. Yet underneath it all, you could be hiding a whole other side of yourself.

But the problem with this type of addiction is that if it is not actively wrecking your life in an obvious way, then it can be quite hard to feel motivated to seek help. After all, if you have a career, relationship and good reputation, then surely you have a handle on it all?

However, it is worth acknowledging that your habit — even if it’s not a full-blown addiction yet — could still covertly be causing long term damage to your body, mind and relationships, even if this isn’t obvious at first. This being the case, what steps can you take to get support?

What is addiction?

Firstly, it might be useful to look at what addiction is in the first place. There are many definitions but a useful one comes from author and addiction expert, Dr. Gabor Maté, who states that ‘an addiction is any behaviour that gives you temporary relief from pain or pleasure, but has long term negative consequences.’ At a physical level, addiction can cause changes in the brain structure, making it very difficult for a person to control their impulses around a particular substance or behaviour.

And while addiction may have a genetic component, it is also commonly linked to childhood trauma and distress. In fact, addiction is a highly complex condition with physical, mental, emotional, familial, environmental and social elements, meaning it can’t necessarily be reduced to the status of a medical illness with a quick fix.

Why are some individuals high-functioning?

But this doesn’t answer the question of why some addicted people can function better than others and live seemingly ‘normal’ — or even successful — lives. However, according to a 2007 study by the National Institutes of Health in the USA, ‘high-functioning addicts’ tend to have certain characteristics, including a high level of education and a stable job. One in three have a family history of addiction and one in four have a history of major depression. And crucially, they often have a strong level of support from loved ones.

This latter point is important, as a high-functioning individual often simply has more ‘enablers’ around them compared to a more marginalised or isolated addicted person. Essentially, an enabler is any person who helps an addicted person to continue with their behaviour — usually unintentionally — and can include a partner, child, family member, friend, work colleague or boss. High-functioning types can often have various enablers who help them to maintain the façade that everything is fine, for instance, the parent who provides financial support when they get in a mess, the spouse who helps them get to work on time so they don’t lose their job, or the manager who overlooks missed deadlines because their talent makes them a valuable asset.

With this kind of support around them, the addicted person can continue to project an image of ‘having it all together’, as they have a ring of protection that buffers them from facing the consequences of their actions. And sometimes, their support network has no idea that they even have an addiction in the first place.

That said, it is also worth noting that high-functioning addicted people can often also be especially talented or skilled in their chosen profession. This means that when something like alcohol consumption impairs their performance, they still might excel at their job regardless, meaning that their addiction goes unnoticed. For some covert addicts, a decreased performance (for them) can still appear dazzling to the outside world, creating a sense in themselves that they are ‘invincible’, have ‘outsmarted the system’ and ‘don’t really have an issue’.

What causes high-functioning addiction?

High-functioning addiction is often linked to high pressure careers, such as being a doctor, lawyer or executive, or professions in which there is exposure to trauma, such as police or firefighters. Additionally, many successful people working in hospitality, sales or entertainment industries — where alcohol and drug use is normalised and, at times, encouraged — develop addictions. That said, it is important to remember that addiction of this kind can affect homemakers, athletes or people in any profession at all. But what all individuals with this issue have in common is that they are able to successfully maintain an image of stability, often for many years. They may also be in deep denial that they have a problem, concealing their condition from themselves as much as from anyone else.

Alcohol in particular can often be the drug of choice for high-functioning individuals, as they might use drinking as a socially acceptable ‘reward’ at the end of a hard day. And if their profession has a culture of drinking (for instance, regular client entertaining), then this can give a façade of respectability to their habit. They may even argue that drinking is ‘all part of the job’, something that is crucial to their promotion opportunities and to being accepted by the team. They may also claim that it would be impossible to cope with the challenges and strain of their career without it.

Also, it is important to understand that some people don’t believe that they are doing well despite their addictive behaviour — they believe that they are doing well because of it. And this is why it can be so hard for them to admit that they have a problem, as they might actually perceive their problem as the ‘secret to their success’. In other words, a useful soothing mechanism and stress outlet for coping with life, or something that fuels enhanced confidence or performance.

And in fact, there can even be a kernel of truth to this belief. Because if a compulsive behaviour is numbing a deep and debilitating emotional pain, then it might indeed be helping them to perform better on a day-to-day basis. However, this type of self-medicating is not a long term solution as the impact of the addiction will catch up with them eventually, whether medically, emotionally, financially or socially.

Signs of high-functioning addiction

If you think that you might have — or be developing — a high-functioning addiction, then there are certain signs that you can look out for. Here are 14 of them (bear in mind that some are only specific to substance addiction):

  • You are consumed by the need to indulge in a specific substance or behaviour, including at odd times of day.
  • You do certain things to excess e.g. drinking, taking cocaine, shopping.
  • You frequently show up late for work, call in sick or feel tired in the mornings.
  • You justify a certain behaviour as necessary e.g. ‘I need to smoke weed to unwind after work’.
  • You overindulge in drink or drugs at social occasions.
  • You could be considered ‘low functioning’ in a specific area of life e.g. a string of rocky romantic relationships.
  • You experience sudden mood swings, out of character behaviour or loss of temper.
  • You experience ‘blackouts’ with no recollection of events.
  • You are experiencing financial issues related to a certain habit, even if you earn a good income.
  • You have a group of friends who also show addictive behaviours e.g. drinkers, drug users or gamblers.
  • You feel you need to cover up an unhealthy appearance e.g. wearing a lot of makeup.
  • You sometimes fail to meet family obligations but make excuses about ‘having ‘a lot on my plate’ or ‘feeling really tired’.
  • You’re losing interest in your hobbies.
  • You’re having memory problems.

Beyond these signs, just like anyone else struggling with an addiction, you might also be grappling with a deep sense of shame and self-criticism, making it feel all the more crucial to appear outwardly ‘successful’.

Barriers to seeking treatment

One of the most painful aspects of addiction is that it can often take years to admit to having a problem. However, for many addicted people, the turning point can be that moment of hitting ‘rock bottom’ — in other words, having the realisation that engaging in this behaviour is ruining their life. Rock bottom can take many forms, including loss of a job or home, being left by a partner, or developing a serious physical health condition.

The problem is that high-functioning addicted people might take much longer to hit rock bottom — or might never reach it at all — preventing them from using ‘the gift of desperation’ as motivation to change. This can be due to the cushions of greater economic security, a strong professional standing and loved ones who act as enablers.

Common excuses might include ‘I haven’t lost anything because of my drinking/cocaine use/gaming’, ‘I still pay the bills’, ‘I can stop anytime I like’ or ‘I only drink quality wines’. You might also have fears about entering into a treatment programme as you could feel ashamed at the loss of control, might view seeking help as a form of weakness and may not want to associate with other ‘addicts’ who are not as highly functioning. You might also feel that you are too indispensable at your job to take time off, or worry about the damage to your professional reputation if word gets out about your issue.

Treatment avenues for high-functioning addiction

If you can relate to any of the above then one good option can be to see a therapist, either online or face-to-face. In fact, various types of therapy have been shown to be effective in treating addiction. For instance, EMDR therapy can help individuals move on from past traumas that have led to their addictive behaviour (as well as breaking the association between the addictive behaviour and the perceived reward). DBT can help addicted people to better manage painful emotions, CFT can help them to address the underlying shame that often drives addictive behaviours, and Schema Therapy can uncover unmet childhood needs that could have contributed to addiction being developed as a coping strategy.

This list is not exhaustive and every addicted person, high-functioning or not, has to find the approach that best suits them (which could include a medical rehab facility if there is a physical addiction). However, clichéd as it might sound, the first step to recovery is recognising that there is a problem in the first place.

One way can be through an intervention from loved ones, who can explain, firmly and calmly, the effect that the addicted person’s behaviour is having on them all. This might help them to see beyond their ‘I’m succeeding so everything is fine’ worldview and recognise the pain that their condition is causing to others.

Family members who have previously been enablers can also have a part to play here by refusing to act this way any longer. This can include recognising their own role as an enabler, setting new boundaries (with consequences for breaking them), and refusing to continue to cover or lie for the addicted person, or to provide further financial or legal help. Where appropriate, loved ones could also suggest seeking shared support, for instance, couples or family therapy.

It can also be worth conveying to the addicted person that their high functioning status might not last forever if the addiction continues. They could find that in the future, issues such as long term physical damage or memory problems could even prevent them from performing their jobs altogether.

Surrendering the facade

Of course, there is no quick fix for addiction, but there is a wide variety of help available. A turning point could be in recognising that a polished and successful outer life doesn’t resolve the inner, often buried pain that could be driving your behaviour. But first of all, that pain needs to be recognised and acknowledged. In the words of Dr. Gabor Maté in his book In the Realm of Hungry Ghosts: Close Encounters with Addiction: ‘It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behaviour.’

If you have this issue, then your motivation for treatment might not necessarily be ‘getting my life together’ as you might already have it all together (at least on the surface). Instead, the motivation might simply be the chance to find a peace and sense of control within yourself that you can’t currently experience.

With the right kind of treatment, you could escape the endless treadmill of having to numb painful emotions and work towards achieving a deeper sense of inner completeness instead. In other words, you can move beyond the exhausting job of projecting a constant façade of success and learn to engage with the world as your true, flawed, vulnerable self instead.

Are you or a loved one dealing with the symptoms of addiction? MTA’s world-class therapists offer a range of expert support, both online and face-to-face.

‘Am I a high-functioning addict?’ How to spot the signs in yourself and loved ones
Clinical Director
Lumo Health team
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