I am Dr. Prasad Shetty here. I am a practicing psychiatrist for the past 20 years and a director of Mumbai Psychiatry Clinics, which is based in Bombay.
Today I will be talking to you two about the concept of a functioning alcoholic, mind you this terminology is not a codable disorder it finds its reference in certain articles on alcoholism. So I'll tell you what do you mean by functional alcoholism or a functional alcoholic.
Normally we use words like alcohol dependence where the patient is dependent on alcohol and without alcohol, his day to day life is a big problem and after stopping alcohol he goes into withdrawal and he goes into delirium tremens and the classical pattern which we see of a patient of alcoholism.
Now there is something known as a functional alcoholic, these are basically people who are working, who are managing their house, they're managing the job well and initially they start with weekend drinking like parties or get-togethers or a social gathering. However over a period of time because of the stressors of day-to-day life or any personal reasons slowly their alcoholism increases. The intake of alcohol increases so instead of weekends they may start taking on weekdays also and most of the times they justify it by saying that I'm stressed out, I have job pressures, I have personal problems, so I am taking some alcohol to relax. They may not drink daily, they may take two or three times a week and sometimes they drink a lot over the weekend then they don't have to go to work.
When confronted they will say that I am earning well, I am going to work daily, I am not bunking my job and I am performing well so if I am functioning well why do you think alcohol is a problem, but when you speak to the relative like their wife or a reliable objective data as we call it, we will come to know that because of his drinking pattern there are certain minor changes in him which he himself does not realize, like for example a little bit of irritability comes in, a little bit of anger comes in.
In Bombay life I can typically give an example if he is driving to work previously if there had been a traffic jam or if someone had tried to overtake him he would not be angry, but nowadays if there is a traffic jam he is not able to wait in the traffic jam or someone shouts he is not able to control his anger so this threshold goes down he starts reacting more and if spoken to his manager, his colleague they will say that he slightly changed, he is functioning at work he is delivering his projects on time, he is doing everything well but he's become a bit snappy and irritable and over a period of time we see that there are changes in his personality both the physical personality and the psychological personality, which he will attribute to stress and work but he will not attribute it to alcohol.
So the biggest problem of a functioning alcoholic is denial. They will not accept that their alcohol has increased and it is overtaking them, they won't say that they're addicted and if told them they will say that I am drinking good scotch liquor, I am doing good whiskey, I am not drinking daily, I am not drinking and falling down, you see the alcoholics around they are creating a commotion, they are beating their wives, they are not going to work, I am a much better person and I know how to handle my personal life and that is the biggest problem with these people who drink and function, but when we do their blood tests at times, when we do their liver function test i.e.LFT, there is a parameter known as the GGPT, the gamma-glutamyl pyruvate transaminase which is an indicator of acute liver damage.
Many a time in these people we need to get the CBC done that is a normal blood count and the other parameters and LFT done with the GGPT and you come to know that the liver is silently suffering some damage. The point is, making these people aware and when they are not convinced through your counseling or talking the blood tests may help you in convincing such people and believing most of these people are very intelligent people that is why they are functioning well at work and they have a good amount of intelligence, they are high-performing guys, so it is very difficult to convince them that they have a disorder.
The biggest danger in functional alcoholics is they may anytime slip over to dependence, like for example at job they have a big setback, they may take to drinking alcohol every day, if there is a death of a dear one in the family they may go to switching to alcohol every day, they suffer a major loss, suppose a major loss in share market or a major loss in investment, they may slip anytime to full-time alcoholism, the only thing they don't realize that they are on the edge. The moment stress or some tension overtakes them they straightaway shift into complete alcoholism and they start drinking daily and that is the time very difficult to control them because like I said they are very intelligent people, they are more intellectual and they are in denial.
So functional alcoholism finds its place, not in textbooks per se and not in this powered textbook of disorders, but it is very well known and this is something which we need to be sensitive about and if you have people around you, I would recommend you to speak to them and tell them to stop it before it becomes a problem, don't wait for it to become a problem.
If you want to know more about this particular topic, if you want to know more about Dr. Prasad Shetty and if you want to know more about Mumbai psychiatric clinics and how to contact us for further knowledge or for further help you can definitely contact us, you can contact us through the Lybrate helpline, there is a Lybrate website so you could definitely approach Lybrate.