When you hear the word “alcoholic”, what image comes to mind?
Is it the drunk, out-of-control father sitting in a recliner, wearing a wife beater and pounding sixers while wreaking havoc on his wife and family?
Is it the stumbling homeless man who smells like ethanol begging for change on the corner and sipping something out of a brown, paper bag?
Maybe it’s Meg Ryan falling over in her shower because she’s pissy drunk at three o’clock in the afternoon a la When a Man Loves a Woman.
The word “alcoholic” is loaded. It’s heavy. Nobody wants it. Yet when our drinking becomes problematic and out of control, it’s often the only thing we’re left with.
But what does it even mean? And WHO does it describe?
What is alcoholism?
The term du jour is actually alcohol abuse disorder (AUD), but it’s basically the same thing. It’s meant to encompass both chronic alcohol abuse and dependence. There are 16 million Americans currently battling various stages of AUD and, of course, it doesn’t happen overnight.
How do we even get on this path? For many of us, we start out experimenting with alcohol and then allowing ourselves to go overboard. Despite the repercussions, we decide it’s worth the excitement to try again.
When you’re young, it’s presented as a rite of passage. Somehow getting trashed and engaging in risky behavior while puking in your friend’s hat and dying the next day of a hangover is normal.
We push the boundaries more. Instead of partying just on the weekends, we add a Wednesday into the mix. Maybe we get a DUI or have a regrettable hookup. Maybe something worse happens.
Par for the course, right? We’ll grow out of our partying ways eventually.
But many of us don’t. We take the alcohol out of the party and into our everyday adult lives.
Early Signs of Alcoholism & Alcohol Abuse
Our little dance with addiction typically starts with occasional binge drinking. It’s that experimental stage I just mentioned. How far can we take it? What’s the most amount of drinking I can do and still drag myself to class or work the next morning?
From there, we progress into weekend drinkers. We go hard every weekend without fail. Drinking becomes the catalyst for getting together with friends.
“Hey, you guys wanna come over and have some drinks?”
The frequency of those invitations increases. You go from drinking as a social activity to drinking as a way to decompress and drinking as stress relief. The invitations become, “I’ve had a horrible day. Want to grab a drink at the bar after work?”
This was my MO during my problem drinking days. I worked a high-stress job that ramped pre-existing mental health problems to unmanageable levels. Rather than get help or switch careers, I drank.
Not alone…at first.
My misery had company for a while. My coworkers and I had our go-to happy hour spot where we drank away the heaviness of our week. I was routinely the first one to get there and the last one to leave.
But that’s where it started.
What are the stages of Alcohol Use Disorder?
Alcohol abuse doesn’t happen suddenly. It’s insidious that way. It is progressive. For anyone questioning their own drinking or feeling concerned about a loved one, it’s useful to understand the stages of alcoholism.
It’s important to get clarity on some basic terms we use when talking about drinking. Talking about alcohol consumption in terms of “heavy” or “too much” is subjective. That is why we’ll use the agreed-upon definition of these terms when discussing health risks associated with alcohol consumption.
Binge drinking is defined as 4+ drinks for men and 3+ drinks for women on a single day or occasion.
Heavy drinking is considered 5 or more episodes of binge drinking in a given month. Once you engage in moderate to heavy drinking on a regular basis, you’re at risk for alcohol dependence.
Your brain becomes accustomed to using alcohol as a way to boost dopamine and deal with stress, boredom, and other unpleasant feelings. It produces less dopamine on its own and becomes dependent on the artificial boost of dopamine from alcohol.
As your brain adjusts to the constant presence of alcohol, it starts to close dopamine receptors, which in turn, forces you to drink more alcohol to get the same effect (more on that in a bit).
At this stage, you might also notice more reckless behaviors appear like driving while drunk or engaging in risky sexual activity.
Social Problems Caused By Drinking
As you begin to enter into the at-risk stage or even early alcohol use disorder, your personal relationships become more seriously effective. Common problems include:
- Losing relationships with others
- Erratic behavior
- No longer receiving social invitations
- Changing friends and social circles frequently
- Struggling to communicate with strangers
I spent years hopping from one social circle to the next. People got sick of my shit. Drunk me could suck the oxygen out of any room and frequently did.
Even when I made an effort to be a better friend or make myself available to others, I couldn’t connect. It felt like my brain was stuck in off-mode.
Despite my efforts, I couldn’t will myself the ability to be an engaged, present friend. I couldn’t shake the feeling that I just wanted to go drink somewhere.
If problem drinking continues unchecked, you may end up physically dependent on alcohol to function. In the dependence stage, you lack control over your drinking. You want to stop or drink less, but you can’t.
This is also the stage where your tolerance increases. Despite the damaging effects of drinking on your overall health, which you can really feel at this point, you continue drinking.
At this stage, you start feeling withdrawal symptoms like tremors, sweating, and irritability. You may also experience insomnia, digestive issues, and a racing heart.
I used to wake up every morning feeling like my heart would explode out of my chest. I tried to bury myself under blankets and pillows to calm down. I’d ask my husband to hold me while I took deep, ash-flavored breaths. (I’m still haunted by memories of next-day breath that no toothpaste could vanquish.)
I desperately needed to stop, but would inevitably go back to drinking as soon as I came home from work.
When you can no longer physically or psychologically function without alcohol, you are officially in the mid-stage alcoholic territory.
I never wanted to end up in that place. In fact, the mere mention of the word “alcoholic” angered me to my core. Once, during an attempt to see a therapist and get help, the topic of my drinking came up.
“I think there’s a problem here,” she said. “You need to go to AA.”
It was painfully obvious she was right and yet I’d never felt so offended.
I told her what she could do with herself and never went back. I was in denial.
Clearly, I ticked all the boxes, and yet the fact that I was able to maintain a job, pay my bills on time, and enjoy an otherwise normal life, made me believe that I was somehow above the whole alcoholic thing.
But I wasn’t. Every medical assessment I took pointed towards a problem, but I was not receptive to the idea and refused help.
If you think you might have a drinking problem, you can also take the following Alcohol Use Disorder Identification Test (AUDIT).
These questions are similar to what a medical professional would ask you, however, it is not a substitute for medical advice or an official diagnosis. Use this quiz as a tool to examine your drinking patterns.
Who gets called an alcoholic?
We’re accustomed to accepting the stigma of alcoholism. Alcoholism is viewed as a personal failure and weakness. It’s an icky word, basically taboo, the kind of word we lower our voice to say.
In my mind, that word was for people who lost their homes and families to alcohol, for people who woke up and drank first thing in the morning, people with hidden bottles stashed around the office.
There was an ugliness to it I did not want.
Despite destroying relationships, burning professional bridges, creating drama in my own family and marriage, I refused to entertain the idea that I, too, was an alcoholic.
It’s why I didn’t get help sooner. In retrospect, it was also stupid on my part to allow my ego and fixation with a label to keep me from getting the help I needed. Hopefully, you won’t make the same mistakes I did.
Do you have to call yourself an alcoholic?
Hot point of contention in the recovery community. I’m not an expert, but my opinion is that you don’t. However, there is a caveat!
You have to admit you have a problem.
My hangup with identifying (or not) as an alcoholic was an excuse I used against myself to continue drinking.
It became an obstacle to my own healing. Rejecting that label meant I was unable to see alcohol as the real villain in my life.
I knew I drank to escape feeling stressed, miserable, and like my life had no joy or meaning. But I didn’t know that alcohol was reshaping my brain in ways that made those conditions worse.
Instead, I focused on the stigma of the label and the ultimately pointless debate over whether I had a “disease” for which there was no “cure.”
I had to shift my focus to sobriety and healing.
If calling yourself an alcoholic is the final step that brings you to sobriety, counseling, and healing (as it has for thousands of people), then that’s what you should do. Embrace it. There is nothing shameful in it.
If, for whatever reason, it prevents you from getting help and quitting alcohol, let it go.
As long as you get sober and turn your life around, what difference does it make?
If you’re rejecting the label alcoholic because you want to leave yourself the option to drink again, that’s a problem. You haven’t accepted that you need to quit drinking yet and, consequently, will likely stay on that relapse merry-go-round.
But if you reject calling yourself an alcoholic because it’s not serving you and you’re living your best, alcohol-free life without it, then I say do what works for you.
Whether or not you identify as an alcoholic is less important than whether you’re getting sober and getting your life back on track.
Know the warning signs of a drinking problem and get help. Everything else is secondary.
Access should not be a barrier to help.
Soberish is proudly sponsored by BetterHelp. If you have tried (and failed) to find a therapist who has the knowledge and background to help you navigate your specific issues, try BetterHelp. Learn more about my counseling journey with BetterHelp or visit their website below.