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Symptoms of Alcoholism: What to Look For

By Gillian Tietz
Here are signs to look for if you think someone you love may have alcoholism, also known as alcohol use disorder (AUD).

If someone you love seems to struggle to control their drinking or to quit, you might wonder if they are struggling with AUD.

A medical professional like a doctor or a psychiatrist needs to diagnose them in order to tell you for sure. But certain warning signs could help you decide whether it’s time to talk with your loved one about getting help.

Symptoms of Alcoholism

According to American Addiction Centers, only medical or mental health professionals (such as psychiatrists) can provide an official alcohol use disorder (AUD) diagnosis. The criteria for this disorder are contained within the American Psychiatric Association's DSM-5, and patients are evaluated for the presence of these criteria witin a 12-month period. A doctor may diagnose mild AUD if a patient meets 2-3 of these criteria. Those meeting 4-5 of these criteria may be diagnosed with a moderate AUD, while those meeting 6 or more criteria may be diagnosed with a severe AUD. The criteria are as follows:

  • Drinking alcohol more often or in higher amounts than intended
  • Being unable to cut back or quit drinking alcohol, despite deliberate attempts to do so
  • Using a significant amount of time to obtain or consume alcohol, or recovering from its effects
  • Having strong cravings for alcohol
  • Being unable to follow through on occupational, domestic, or academic obligations because of repeated alcohol use
  • Persisting in drinking despite social or relationship problems that result from alcohol use. 
  • Curtailing the amount of time spent at work, school, or social/leisure activities that pre-existed alcohol use
  • Repeatedly drinking while completing other activities that become physically dangerous with the introduction of alcohol, such as driving or machine operation
  • Persisting in drinking despite chronic pnysical or psychological problems related to alcohol use. 
  • Experiencing tolerance: It becomes necessary to drink higher and higher amounts of alcohol in order to produce previous desired effects
  • Having withdrawal symptoms such as tremors, restlessness, nausea, sweating, racing heart, seizures, or hallucinations while attempting to stop or lessen alcohol use

AUD causes lasting changes in the brain which make individuals vulnerable to relapse. However, evidence-based treatment including therapy, support groups, and/or medications can help people with AUD maintain recovery.

A high functioning individual with an alcohol use disorder may not be the stereotype that comes to mind when we think of an alcoholic.” explains Dr. Vanessa Kennedy, Director of Psychology of Driftwood Recovery. “These individuals do not typically experience the type of life-altering consequences that someone with a “low bottom” may experience in their addiction, such as legal consequences, injuries or health problems, or job loss. Examples of high-functioning alcoholism:

  • A stay-at-home parent who is able to drop off and pick up children from school and keep up with some tasks, but drinks more than intended in the evenings, is unable to cut back, experiences cravings and irritability when not drinking, is experiencing disruptions in sleep, and is struggling to participate in social, partner, and parenting roles.
  • A high-performing sales executive who thrives in a demanding career that requires drinking socially with colleagues and clients but is noticing strained relationships, increased risk-taking behavior such as driving under the influence or impulsive decisions, and a sharp increase in alcohol tolerance.
  • A retired individual who drinks throughout the day routinely and has a high tolerance, engages in social events, but has begun to engage in more dangerous behaviors when drinking, such as operating power tools and woodworking.”

How Do Those with AUD Behave in Relationships?

People with abusive behaviors may become more abusive if they also have AUD, but AUD itself doesn't cause people to be abusive.” Kara Nassour, LPC, NCC from Shaded Bough Counseling tells WebMD Connect to Care. “AUD can also lead to secrecy and dishonesty because many people with AUD feel a deep shame around it, or don't feel ready to quit drinking.”

According to American Addiction Centers, you might notice behavioral changes in your loved one if they are struggling with AUD. They may become angry or moody, and show less interest in relationships, work, school, or hobbies they once enjoyed. Alcohol impairs cognitive functioning and reduces physical capabilities, which can result in a neglect of work and home responsibilities. Your loved one may also spend a lot of time nursing their hangovers.

How Does Alcohol Affect Other People’s Lives?

Many lives are impacted by a person’s drinking. According to American Addiction Centers, addiction can lead to a number of consequences in the workplace including missed work due to hangovers, reduced productivity, frequent mistakes or missed deadlines, and potential accidents. 

“People who struggle in their relationship with alcohol tend to disconnect themselves from their surroundings at some level.” Annie Grace, author of This Naked Mind and The Alcohol Experiment tells WebMD Connect to Care. “That can naturally compromise any relationship - whether it’s friends, family, colleagues. From poor work performance to isolation to infidelity, when the escape alcohol has offered someone ultimately becomes an unbreakable cycle, the people around them also suffer.” 

However, this doesn’t mean that a person with AUD should automatically be removed from your life. “It's important for those who become upset with someone's drinking behavior to understand that the person drinking is even more upset with themselves. And, despite any disconnection, it is actually compassionate connection with others that is the most important thing in recognizing the need for change,” Grace says.

Therefore, holding boundaries for your own safety and wellness is important, but offering healthy support when you can could also help your loved one make the right decision to begin treatment for their addiction.

How Can Families Be Affected By Alcohol?

If your loved one has an untreated alcohol use disorder, it could end up hurting their relationship with you and other people they’re close to. That’s because addiction is a disease with far-reaching effects.

"The effect on the family varies based upon who is affected with the disease," says Lawrence Weinstein, MD, Chief Medical Officer for American Addiction Centers. "If a parent is addicted to alcohol, their child may be forced to take on responsibilities beyond their years."

Weinstein says this can lead to feelings of anger and abandonment in the child, and can affect them throughout their entire life. It could eventually impact the way they parent, too.

“If the person addicted to alcohol has parents and/or siblings, there are a vast number of potential effects," he says. "Siblings may feel neglected and come to resent the sibling with the addiction, as well as their parents. Additionally, parents can experience anxiety, depression, stress, and even develop ailments as a result of their child with addiction."

Alcohol addiction will get worse over time if left untreated

"Alcohol is the third leading cause of preventable death, so prolonged alcohol use causes a great deal of damage, then, eventually, death," says Weinstein. 

That’s why early treatment is key.

Problematic alcohol use also makes the user's loved ones worry greatly, and it can cause financial stress or interfere with the user's ability to be fully present in their relationships.” adds Kara Nassour, LPC, NCC. “Children who grow up seeing a parent struggle with AUD are also more likely to develop AUD themselves.”

When is Drinking a Problem in a Relationship?

The problem with most substance use disorders is that it is not a problem, until it is a problem.” John Maggio, MA, LCADC, LAC from Maggio Wellness tells WebMD Connect to Care. “When drinking is a problem, it usually results from the negative impact on relationships around them and the deterioration of their support network, their inability to manage their responsibilities, causing them to isolate or stop activities they once found enjoyable, and possible health concerns.”

According to American Addiction Centers, addiction can lead to behaviors that damage relationships, such as secrecy, angry outbursts, and neglect. These can cause trust issues in the relationship, which can lead to other damaging emotions like jealousy, fear, anger and resentment. You may also feel compelled to cover for your loved one for missing work or their behavior at social events.

If you feel afraid, angry or resentful due to your loved one’s drinking, then it may be a sign that drinking is causing issues in your relationship.

Getting Help

There are many options available for help, including: 

  • Individual and family counseling
  • Substance abuse treatment programs
  • Prescription medication for alcohol dependence
  • Support groups like Alcoholics Anonymous (AA) and other 12-step programs

Loved ones of alcoholics can join support groups like Al-Anon. These are mutual support programs for people whose lives have been affected by someone else's drinking. By sharing common experiences, families and friends can bring positive changes to their own individual situations, whether or not their loved one with alcoholism is ready for change. 

There are also many ways to support a loved one who is in recovery, including educating yourself on alcohol use disorder, being a role model in your own lifestyle by reducing or eliminating alcohol, and making sure to practice self-care and not neglect your own physical and mental health.

Remember to be compassionate – changing an alcohol use disorder takes patience and might involve giving up a big part of one’s life, e.g., a group of neighborhood golfing friends who love cocktail hour may need to be replaced.” Dr. Vanessa Kennedy tells WebMD Connect to care.

Don't Wait. Get Help Now. 

If you or a loved one are struggling with addiction, WebMD Connect to Care Advisors are standing by to help.

Treatment & Resources for Alcohol Addiction