Clinically reviewed by Dr. John Dyben, DHSc, LMFT, MCAP, – Chief Clinical Officer, Hanley Center
Some people are successful and able to carry on with their careers, maintain relationships, and meet their obligations even though they are battling an alcohol or drug addiction. People who fit this description are usually called “high-functioning” because it seems that they have everything under control.
Their success can make it difficult for both others and themselves to realize there is a problem.
The truth is that a person does not have to experience a serious downturn in order for an addiction to be considered real, and by waiting for someone to ‘hit rock bottom,’ you might delay getting them the treatment they need, which can cause the disease to progress and often leads to serious consequences.
The Myth of Rock Bottom
For many years, people believed individuals only sought help after suffering serious losses. Some people seek treatment after they have lost it all, but research shows that waiting until so-called rock bottom can be detrimental or even deadly.
Substance use disorders are chronic diseases that can exist long before any effects appear. A person may still perform well in their career even as their dependence increases.
Professional success often delays recognition of the problem. High income, social position, and career accomplishments can lead to a false sense of having control over the situation and conceal the severity of their substance use.
Even High-Achieving Professionals Are Vulnerable to Addiction
High-achieving professionals in high-stakes positions may turn to substances to relax, sleep, or deal with anxiety. This can be a recipe for disaster and can develop into addiction. Certain personality traits that contribute to career success can also create vulnerability to addiction, including:
- Perfectionism
- Competitiveness
- Unwillingness to ask for help
- Fear of failure
- Imposter syndrome
- Strong desire to maintain control
Professionals may feel they can fix their problems on their own and may struggle to admit they have a problem because it doesn’t match the narrative that they are successful.
What High-Functioning Addiction Looks Like
The warning signs are generally rather mild because these people continue to meet their responsibilities. A high-functioning professional may:
- Use alcohol every evening to “unwind”
- Depending on alcohol or substances to sleep or manage stress
- Increase consumption over time due to tolerance
- Hiding the amount they drink or use
- Defensive when asked about substance use
- Have mood swings and irritability, or experience anxiety
- Experience memory or concentration problems
- Withdraw from family and close relationships
- Feel unable to stop on their own despite wanting to
People with substance use issues can still get promotions, meet deadlines, and keep up with their social lives, but inside they often feel tired, disconnected, anxious, or trapped by their dependence.
The Cost of Staying Functional
High-functioning addiction can go undetected for years. Even if a person’s performance stays the same, addiction usually has a negative impact on their physical health, mental well-being, and relationships. Use of alcohol and substances can result in sleep disturbances, depression, anxiety, cardiovascular problems, liver disease, cognitive impairment, and more.
Many professionals may appear confident and successful in public while feeling ashamed, isolated, and misusing substances in private. The fact is that addiction can develop as time goes on, because a person is functioning and working today does not guarantee that they will be able to carry on tomorrow.
Why Professionals Delay Treatment
Fear of judgment can be a barrier to getting treatment. They may worry that getting help for addiction could jeopardize their careers, reputations, professional licenses, or community standing. Many believe that as long as they are still successful, their substance use isn’t a problem. Others may fear appearing weak or incompetent if they can’t quit on their own. Unfortunately, these beliefs generally persist and thus continue the suffering.
Concerns about stigma and the possible effects this might have on one’s career are among the primary reasons why people do not get treatment for substance use disorders.
The good news is that today’s treatment methods are more adaptable, private, and customized to the individual than ever before.
Recovery Doesn’t Require a Crisis
For professionals who have a problem with substance use, it is important to realize that they need not lose all they have before getting help. Getting help for substance use before it causes serious damage can protect one’s career, improve relationships, and restore health and quality of life. Many people who enter treatment without hitting “rock bottom” find that they had simply been surviving rather than thriving.
Finding Help
If this sounds like you or someone you love, it might be time to consider seeking help for addiction. You do not need to wait until a DUI, loss of employment, or health crisis to seek help; if alcohol or drugs have become necessary to cope, relax, sleep, or function, then you should have an open conversation with a healthcare professional or an addiction specialist.
At Hanley Center, we know that addiction usually does not present itself in the way people expect. Many of the people who come to us are successful professionals, executives, healthcare professionals, and community leaders who have been in active addiction and continued to pursue their careers and responsibilities. Because of their outward success, it became harder for them to realize when they needed help.
The Headwaters program at Hanley Center provides specialized treatment for addiction to executives and other high-performing professionals with a higher level of privacy and flexibility. Headwaters provides personalized care and comprehensive support for any co-occurring mental health problems. This helps our patients address any underlying trauma that may have caused their substance use, while at the same time laying the foundation for long-term recovery.
If you or a loved one is struggling with alcohol or drug use, Hanley Center is here to help. Whether through our age and gender-specific treatment programs or care offered through Headwaters’ executive program, healing can begin today, no matter where you are in your journey.Call today at (561) 841-1033.
References:
Hammarlund, R., Crapanzano, K. A., Luce, L., Mulligan, L., & Ward, K. M. (2018). Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug- and alcohol-use disorders. Substance Abuse and Rehabilitation, 9, 115–136. https://doi.org/10.2147/SAR.S183256
Moss, H. B., Chen, C. M., & Yi, H. Y. (2007). Subtypes of alcohol dependence in a nationally representative sample. Drug and Alcohol Dependence, 91(2–3), 149–158. hhttps://www.sciencedirect.com/science/article/abs/pii/S0376871607002189
National Institute on Drug Abuse. (2024). Drugs, brains, and behavior: The science of addiction. National Institutes of Health. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction
National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (3rd ed.). National Institutes of Health. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014. Mayo Clinic Proceedings, 90(12), 1600–1613. https://www.mayoclinicproceedings.org/article/S0025-6196(15)00716-8/abstract
Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (NSDUH). U.S. Department of Health and Human Services. https://www.samhsa.gov/data/
