Living with an Alcoholic

When you love someone, it is only natural to see the best in them and to want to make them happy.

Of course, there are times when that feels impossible; living with someone who has an alcohol use disorder (AUD) or an alcohol dependency is undeniably difficult.

The mood swings, secrecy, and often violent outbursts are upsetting enough, but for many people, it is the negative effects upon the person they love which people find most distressing.

When someone you love is struggling with addiction it can be hard to know how best to help them, and by the time many people consider professional help they have already tried everything from bribery to an ultimatum.

If you are living with someone who is struggling with alcohol dependency the most important thing for you is to remember that it is not your fault. Addiction is not something that any person chooses, and it is not something that anyone person can ‘fix’.

Just as alcohol dependency is caused by a range of complex factors, including genetics, mental health, and circumstances, so too is finding sobriety a complex undertaking.

In order to find this path, help will no doubt be needed from medical professionals or people with a more personal understanding of the struggles that come with this affliction.

All you can do is support your family, take care of yourself, and keep an eye out for the opportune moment to intervene and nudge your loved one towards the path of recovery.

Until that moment comes, there are some things that anyone living with an alcoholic (or someone they suspect may be an alcoholic) should know.

What is an Alcohol Use Disorder?

An Alcohol Use Disorder (ADU), which is sometimes called alcoholism or alcohol addiction, is not the same as alcohol dependence, though they can present similar symptoms and behaviours.

Whereas AUD is a chronic, relapsing brain disease which manifests as habitual, and indeed compulsive, consumption of alcohol [1], alcohol dependency is a behavioural reliance on alcohol as a response to stress and negative emotional experiences.

While it’s only natural to feel alone when someone you love is struggling with AUD, you are, in fact, in good company; around 15.1 million adults in America alone struggle with AUD, though it is almost twice as likely to affect men [2].

It’s not always easy to tell if you are living with an alcoholic, however, as there are many who function well with AUD.

The National Institute of Alcohol Abuse and Alcoholism (NIAAA), however, has issued guidelines which may be of help.

How to Tell if Your Loved One is an Alcoholic

According to the NIAAA, there are 11 criteria which can be used to identify someone struggling with alcohol abuse or addiction; anyone who meets 2 or more of these criteria in one year would be classed as suffering from AUD, though the severity is decided by how many they meet in total.

These 11 criteria are [3]:

Experiencing periods where they drink more, or for longer, than they intended to.
Trying to cut down or stop drinking more than once without success.
Spending a lot of time drinking, or otherwise recovering from the after-effects of drinking.
Experiencing a strong craving or compulsion to drink.
Finding that drinking, or the side effects of drinking, frequently interfere with personal obligations.
Continuing to drink despite it causing problems.
Giving up on activities that bring joy in order to drink.
Getting into dangerous situations because of drink (e.g. unsafe sex, drink driving) on more than one occasion.
Continuing to drink despite it causing depression, anxiety, or memory blackouts.
Requiring progressively more alcohol in order to get the desired effect.
Finding that alcohol withdrawal causes negative side effects (beyond those associated with a hangover, i.e. trouble sleeping, irritability, restlessness, sweating, or nausea).

Frequent or compulsive binge drinking (defined as drinking more than 8 units of alcohol in a single session for men, or 6 or more units in a single session for women [4]) is also a red flag for AUD.

The Key Challenges of Living With an Alcoholic

Living with a spouse, partner, or parent who is struggling with alcohol addiction is tough, and while every situation is different there are some commonalities which many spouses, parents, and children of AUD sufferers report.

These include:

Frustration.
Anxiety.
Difficulty sleeping.
Isolation.
Shame.
Fear as a result of emotional and physical abuse.
Suicidal thoughts.
Financial difficulties.
Threats of suicide from the partner, child, or parent dealing with alcoholism.

Sadly, domestic abuse is all too common an occurrence in homes where alcoholism is an issue; the World Health Organization found that 55% of assaults by one partner against another (in the USA) occurred after the assailant had been drinking [5].

The same study found that a common cause of the arguments preceding these assaults were accusations of infidelity [6].

These short-term, in the moment challenges, are tough enough, but there are also long-term effects to contend with.

The Long-Term Effects of Living With an Alcoholic

Any person living with an alcoholic partner may face a number of challenges and stresses on a day-to-day basis, and while these are difficult enough there are also potential long-term effects to consider.

These effects come in two forms, generally speaking: those caused directly by the party struggling with AUD, and those formed by those around them in an attempt to cope with their situation.

1. Unhealthy Coping Mechanisms

Those who live with alcoholic partners for a long time often form unhealthy coping strategies in order to manage the mood swings, abuse, and periods of drunkenness and sobriety that are so common. The most common coping mechanisms are avoidance, withdrawal, denial, substance abuse, or displacement of their frustration.

3. Avoidance and Withdrawal

By isolating themselves from friends and family who raise concerns about their partner, spouses seek to avoid the problem at hand in order to gain temporary relief. This is not an effective strategy. however, and generally results in the problem snowballing.

4. Denial

Often a part of enabling behaviour, a partner may deny that there is, in fact, a problem by putting on a brave face, making excuses for their loved one, taking on extra responsibilities to make up the shortfall, and even give their spouse money to keep the peace.

5. Substance Abuse

Substance abuse is not the only directly damaging coping mechanism taken up by spouses living with an alcoholic partner, but it is one of the most worrying.

Other displacement or distracting activities may include excessive shopping, self-harm, infidelity, or excessive online gaming or gambling.

6. Displacement

In many cases, the spouse of an alcoholic will begin to displace their anger and frustration by lashing out at their children, family, or close friends.

7. Trauma and Separation

There are many lasting issues which come about as the result of living with a person who struggles with alcohol addiction, These include, but are not limited to:

PTSD as a result of physical or sexual assault.
Estrangement between children and parents.
Marriage breakdown.
Debt.
Mental illness.
Social isolation.

As every situation is different the long-term effects of a relationship with an alcoholic are never the same, however, the effects common to the majority of marriages in one study were separation, estrangement from family (in particular children), and an increased chance of violence [7].

8. Codependency

Finally, in relationships which seem to withstand the effects of AUD one of the most common effects is codependency.

In such cases, the spouse of an alcoholic, and very often the rest of their family, will take on the duties and roles that an under-functioning alcoholic is incapable, or unwilling, of fulfilling.

In these cases, spouses often become preoccupied with the behaviours of their spouse and overperform in order to stabilize the family environment, but also as a way to increase self-esteem and create a sense of identity.

The Effects of AUD on Children

In cases where one or both parents struggle with AUD or alcohol dependency, the effects are felt most keenly by any children in the family.

Millions of children across the world are living with at least one parent who suffers from AUD, and while many of them risk facing alcoholism in their own lives there are also a number of other common effects to contend with.

The children of AUD sufferers experience many challenges in adult life including [8]:

- Compulsive lying.
- Impulsive behaviour.
- A strong desire to be accepted and affirmed.
- Difficulties with intimacy and developing strong relationships.
- Self-loathing and self-judgement.

These, often psychological, consequences can cause real problems in later life.

How to Cope When Your Partner Has an AUD

For many people, coping with a partner who has AUD is tough; very often the first priority their partner has is to support them, often at the expense of their own health and wellbeing.

This is why it can be tough to hear that your own behaviour is damaging to both yourself and your partners’ chances of recovery.

That’s not to say that this is your fault; the most important thing to keep in mind when struggling with an alcohol dependent partner is that you are not to blame.

Of course, it can be hard to do this when your partner tries to shift the blame onto you (a behaviour common in alcoholics), but it is important that you do not buy into it. There are other things you should do (and not do) in order to effectively navigate these waters.

1. Don’t Take it Personally

Just as you should not blame yourself for your partners’ actions and drinking, it is key that you remember that their aggression, violence, lies, and broken promises are not a reflection on their love for you. AUD is a compulsive disease that takes control away from those who struggle with it.

The way in which AUD changes brain chemistry means that your partner may even be shocked by their own choices.

2. Don’t Cover it Up

Many alcoholics will try to hide the extent of the issue from everyone, and should you become a party to it they may try to make you complicit.

Do not cover up the extent or nature of the problem; you will only feed into their denial and prolong the struggle.

3. Set Boundaries (Don’t Enable)

It is only natural that you want to protect and care for your partner, but there are times when trying to help them can be unhealthy. Accepting unreasonable or aggressive behaviour is just the start.

When you brush their bad actions under the rug you begin a process of enabling that will prevent them from reaching a necessary crisis point. When you allow bad behaviour, facilitate drinking, and protect an alcoholic from the consequences of these actions you take the focus off of the real problem.

4. Let the Crisis Play Out

It is only natural that you should want to help your partner, but it is important that you accept you cannot control or cure AUD for your partner.

Sometimes the kindest, healthiest thing that you can do is sit back and let the crisis happen so that your partner can experience the consequences that their actions have.

Of course, that’s not to say you should create a crisis, but you should refrain from stepping in to smooth over or ‘fix’ the problems they cause for themselves.

In the end, there will come a time when your spouse must seek help, or you need to leave. This may sound harsh, but for many alcoholics, family intervention and separation are the final pushes that they need in order to face the problem at hand.

What to do When it’s Time to Act

There is always a tipping point when it comes to substance or alcohol abuse; a point at which the partners and family of those struggling with addiction must decide whether to intervene, or leave.

For many, the thought of leaving their spouse in a time of need goes against everything they stand for, but it can be necessary.

While support and love can help an alcoholic to recover, you should never stay in a relationship at the cost of your own health and wellbeing.

When to Leave

To put it simply, you should leave your partner if their behaviour is dangerous to yourself or your children.

While it is understandable that you wish to help them, any environment where physical violence is likely, where your mental health is suffering, or your children are facing neglect, abuse, or emotional damage as a result of your partners’ behaviour. Such trauma can have long-lasting effects for you and your children, as previously explored.

Sometimes we can cause more harm than good when we stick around [9].

Deciding to leave, however, is a huge step that many people fear to take; if you’re not yet ready to leave there are some coping strategies which you can employ to minimise negative effects in the meantime.

First and foremost, you should consider removing your children from the situation even if you yourself are not ready to leave. Secondly, you should set boundaries and stick to them; remove yourself from the house if violence occurs, do not facilitate drinking, and seek to open lines of communication about your partners’ issues with alcohol.

If at any time you feel you are in danger you should leave immediately.

Staging an Intervention

When you reach a point of crisis and all other attempts to address the issue of alcohol have been unsuccessful and intervention is often the next step.

Interventions can take many forms, but they tend to be meetings in which those close to the person in question confront the issue of alcohol head-on and ask the person struggling with addiction to do the same.

If you feel that this would be a suitable path for you and your loved ones you should first make sure that everyone is on board, and develop a plan of care before the meeting takes place.

There are intervention specialists who can help you to prepare and respond to challenges effectively.

The end goal of an intervention should be to get your partner to accept that they need help and actively seek it out.

Getting the Help You Need

If you are able to convince your partner to confront their alcoholism and seek the help they need, you will be pleased to know that there are many programs out there ready to help. The most obvious and accessible, of course, is Alcoholics Anonymous.

Run by people who have experienced AUD and found sobriety for the purpose of helping others, AA is of great help to many people around the world (there are some 115,000 groups worldwide [10]). Of course, they are not the only option.

There are also live-in treatment centres and non-12-step mutual help groups which operate with the goal of helping alcoholics to find a path to recovery and sobriety.

The most important thing to do is to research the options in your local area and to communicate clearly with your partner about these options.

Studies have found that AA alternatives have similar success rates [11], but that active participation and a desire to recover are fundamental in deciding the effectiveness of treatment for many struggling with AUD.

Living with an alcoholic is not easy; seeing someone that you love to be taken over by their addiction, and feeling powerless to help is tough, and a desire to help them is to be expected. Nonetheless, you must put your own health, and the wellbeing of any children in the family, first.

Remember; alcoholism is a disease and recovery is possible. You are neither to blame nor in control, but with the right help, you and your family can heal.