Dear Therapist, How do I know if I’ve crossed the line from ‘social drinker’ to ‘alcoholic’? Can I have a healthy relationship with alcohol?
Frame therapist Maggie Malone weighs in...
Excellent question! It comes up a lot in my discussions with clients and, honestly, with friends and acquaintances. Our culture’s obsession with alcohol can really complicate our understanding of what is “normal” drinking. Social drinking is widely accepted and encouraged in the U.S.
So how many drinks is too many? For reference, the Dietary Guidelines for Americans recommends not drinking at all or drinking in moderation by limiting alcohol consumption to two drinks or less a day for men and one drink or less a day for women.
But what really can distinguish someone from having a healthy relationship with alcohol or having an unhealthy relationship can be some specific signs.
7 Signs of Problematic, or Unhealthy, Drinking.
#1: You Use Alcohol in an Attempt to Control Your Feelings
You’re using alcohol to try to feel less stressed or to escape other uncomfortable feelings. Conversely, you may also use alcohol to try to create or continue positive feelings. It may be a way you reward yourself.
Sure, drinking may initially do what you’re hoping, but in the long-term, it’s making you feel emotionally worse. For people with depressive and anxiety symptoms, you may notice them worsening after a night of drinking. The positive side effects we get from alcohol tend to peak pretty quickly and can’t be sustained.
#2: You Drink More Than You Intend To
Once you’ve started drinking, you either don’t realize when it’s time to stop, or even if you do, you find yourself continuing to drink. Your intentions go out the window, and even if you’re only drinking at social events, you still find yourself drinking to the point of getting sick or blacking out.
Maybe you’ve tried to set boundaries around your drinking, like “I’ll only drink on the weekends” or “I’ll only have two drinks,” but you can’t seem to stick to those limits and end up breaking them.
#3: Alcohol Consumes Your Time
Not only are you maybe spending more time drinking than you’d like, but even thinking about alcohol consumes your time. Your mind is preoccupied with drinking. You find yourself wondering if you have enough, when and how you’ll get more, and when the next time you get to drink will be.
Then after you’ve been drinking, you have to also spend time recuperating, maybe sleeping it off, or maybe dealing with the consequences of what happened when you were inebriated. This pattern can quickly become an exhausting loop. It may be hard to imagine your life without alcohol.
#4: Your Tolerance Has Increased
Tolerance means that more and more alcohol is needed for you to feel the effects that you used to feel with a smaller amount. When you first started drinking, it probably didn’t take much to feel tipsy or get drunk. Over time, it takes more and more alcohol to get near the desired effect.
#5: You’re Keeping Secrets
You find yourself lying about how much you’ve had to drink. If you live with others, you may have to hide your bottles or cans from them. You also may start to make up excuses about why you can’t do things to hide your drinking or because it would prevent you from drinking.
Even if you used to only drink socially, maybe you’ve started drinking alone more so that others don’t see it and comment on it. You give less time and energy to things that used to be important to you because you’re choosing to drink instead.
#6: You Do Risky Things When Drinking
We all know that alcohol lowers our inhibitions. You may find yourself acting in ways that you later feel guilty or ashamed about, such as drunk driving, finding yourself in unsafe situations, sending inappropriate messages, having unprotected sex, and any other number of risky behaviors when drunk. Which leads nicely into the next point . . .
#7: You Continue to Drink Despite Problems Related to Drinking
Your drinking has led to trouble in your relationships, your work, your health, your finances, and possibly even your legal freedom. Friends or family may have expressed concern about your drinking. Despite the negative consequences, you can’t seem to quit and “give it up.” Historically, you have downplayed these issues, gotten defensive, or even denied that alcohol has contributed to any problems.
If any of the above signs resonate with you, you could benefit from talking to a professional about your relationship to alcohol.
For many people, noticing that they have questions and are already unsure about their drinking can signal that their alcohol use isn’t healthy.
I’m ready to examine my drinking more closely. What should I do next?
You can reach out to a therapist or counselor who specializes in alcohol or substance use disorders. If your alcohol use has become very regular and you experience withdrawal symptoms between periods of drinking, then you will need medical help to safely detox.
Having a complicated relationship with alcohol doesn’t automatically mean you need to go to a residential rehab program. People work on their relationship with alcohol in a variety of settings - outpatient with individual and group therapy, in peer support groups like AA, SMART Recovery, and Recovery Dharma, intensive outpatient programs, and residential programs.
It may be helpful to bring up your concern with your doctor or therapist, as they can help guide you to an appropriate treatment program based on your needs.
Remember, recovery is possible, even for those people who may deem themselves “hopeless.” Start by getting honest with yourself and others about what you’re struggling with. From there, you can make the daily choice to not drink, to develop a realistic plan, to seek out and accept help, and to take recovery one day at a time.
About the author: Maggie Malone is a licensed individual and group therapist in Georgia, as well as the owner of Rosebud Psychotherapy. She primarily works with women around anxiety, self-esteem, codependency, and substance use concerns. She has worked in both residential, partial hospitalization, and intensive outpatient treatment settings for substance use disorders. Maggie offers a virtual therapy group for women in Georgia who have recently quit drinking called Thriving in Recovery. Connect with Maggie or view more of their work at their Frame profile.
Welcome to our content series "Ask a Therapist" featuring real user-submitted questions, and the follow-up answers from Frame Therapists. We believe that everyone can benefit from hearing how people, just like them, get through their struggles, learn and grow.
Have a question you'd like to "Ask a Therapist"? Submit Your Question Here
** This blog series is not suited for people who are in immediate crisis. If you are in crisis, please call National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or contact Crisis Text Line by texting TALK to 741741.