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Study for Bar at the Folies-Bergere 1882 Painting by Edouard Manet

Dear Sober Lady,

About 25 years ago, in my late 20s, I went to AA for the first time and got sober for about a year. I didn't go primarily because of alcohol--although I did feel like I was drinking too much at the time--but mostly because I was broke and I needed therapy, and it was free.

I remember running into the mother of a childhood friend there; I told her I wasn't sure I was an alcoholic, and she said, "Oh, me too. I come and go to AA." And that's how it's been for me: I never had a major moment of getting sober; I just gradually drank less and less over the years. (At one point, a friend with decades of sobriety told me I wasn't an alcoholic and shouldn't call myself that.)

For many years, I was a one-cocktail-a-night person, and as I got deeper into middle age and menopause, I just got physically worse at metabolizing alcohol (2 drinks and I'll wake up during the night sweating and feeling poisoned). At this point, I oftentimes forget about alcohol, and I go long periods without drinking at all. But I drank more regularly this summer, and now I've reeled it back in. I don't know, it comes and goes. I don't want to downplay it: it's still a struggle sometimes. Is this behavior the sign of a problem?

I read your blog avidly, even though I'm not a 100% sober lady.

Sincerely,

Maybe This is Functional Alcoholism

Hi Maybe,

Thank you for writing in (and your avid readership)! With all the caveats that I’m not a doctor or licensed mental health professional, I wouldn’t describe anything you mentioned in your email as an indicator of a severe alcohol use disorder (alcoholism). Specifically, the part where you say “I oftentimes forget about alcohol, and I go long periods without drinking at all” is not typically a statement I associate with people who are addicted to alcohol.

What’s far more important than what you call yourself (or what your friend thinks you should call yourself) is the impact your alcohol use is having on your life. The great news is that it sounds like you’re very cognizant of how alcohol makes you feel physically and are responsive to that. If two drinks make you feel like hell, then cutting back is absolutely the right call and sounds like something you can do without much heartache. It’s a great sign.

Ask me a question or send feedback!

Just because you don’t necessarily have a consistent relationship with alcohol doesn’t mean you have a problem with it. If I were to replace drinking/alcohol in your email with, I don’t know, cupcakes or something, you probably wouldn’t be asking me if you had a functional cupcake addiction. We all go through cyclical phases of substance use or other behaviors that don’t necessarily fall into the category of compulsive use.

That said, something is clearly making you question your alcohol use, and whatever that thing is, it’s worth exploring. You’ve explained how drinking makes you feel physically, but what about the impact on your life otherwise? When you drink, do you say or do things you regret? Do you drink more than you intended to? Does drinking get in the way of your daily tasks, like appointments, laundry, etc.? Do you become preoccupied with drinking? Do you plan your social activities around drinking (or do you avoid people who don’t drink or might judge you for drinking)?

The above questions are just some of the criteria clinicians will ask you to evaluate to help them determine if you have an alcohol use disorder and, if so, what the severity of it is.

But you don’t have to have AUD to want help cutting back on your alcohol intake. Many women find that they’re much more sensitive to alcohol during and after menopause, and if you decide that you don’t want to drink because those effects are too miserable, your doctor may have suggestions that help with any cravings that arise.

Take some time to reflect and get really clear on what you want your life to look like and the role that alcohol is currently playing in it. Do you want to stop drinking altogether? Do you wish that you could be more consistent, so you don’t go through periods of drinking more and then feeling the need to stop completely? Do you want to reserve any alcohol consumption for special occasions? Write these down.

Where are you in relation to those goals? What’s standing in the way of you achieving them? Keep track of your progress, any backsliding that happens, and how you feel about it all. Don’t worry so much about labels (I may be in the minority, but I think the term “functional alcoholic” is largely an oxymoron, anyway). This is about figuring out how you want to feel and what you want your relationship with alcohol to be. Think of it as a process of discovery more than an ‘Am I healthy or unhealthy’ exercise.

More than anything, be kind to yourself. We live in a world that’s constantly sending us powerful and conflicting messages about alcohol while also living in a society where excessive alcohol use is fairly normalized. It’s not easy to figure things out, and the temptation to use others as a barometer is strong. But at the end of the day, you get to decide what you want for your life. Once you’ve clarified that, there are plenty of doctors, friends, and internet advice columnists who can help you get there.

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I’m not a doctor or mental health professional, so my advice shouldn’t be construed as medical or therapeutic. You are free to take or leave it.

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Am I a 'functional alcoholic'?