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Are you a functioning alcoholic? – and the signs you may need help

Like many busy working mothers, 47-year-old Joanna Schillings is always rushing. Rushing to get ready in the morning, and to get her two children to school. 

Rushing to get to a meeting, then to meet a friend for lunch. Rushing to collect the kids, and then home again in time to prepare dinner for her husband.

And for years the freelance stockmarket trader would be sure to squeeze in her daily pit stop at the supermarket.

With the children waiting in the car, she’d bolt down the aisles to grab two or three bottles of pinot noir.

‘The kids didn’t think anything of it. It was just accepted that Mummy drank lots of wine,’ says the mother-of-two.

When the clock struck 4.30pm, she’d pour the first glass. And by 6pm, most nights, she’d finished a bottle. Most weekends were spent visiting friends’ houses, fuelled by champagne – and not much food. 

Experts say functioning alcoholics’ drinking is usually triggered by difficult life events. This rings true for 41-year-old Samantha Cole (above), a toy-shop owner from Barry, South Wales. While the mother-of-three had ‘liked a good drink’ since her late teens, the habit revved up after the breakdown of her relationship 13 years ago, leaving her alone with her toddler daughter

‘It was the lifestyle both me and my husband were used to. It wasn’t uncommon to polish off five bottles of rosé during a midweek lunch with a couple of colleagues.

‘Every morning, without fail, I’d get up at 7am for work, blow-dry my hair and put my make-up on, and get the kids ready for school.’

By the end of 2019, things had spiralled out of control. One evening, having followed her regular drinking routine, she blacked out.

‘I woke up on the sofa with no memory of how I’d got there, nor of any of the events of the evening before – including conversations I’d apparently had with my children,’ she says.

‘I’d also started craving a drink earlier. I’d even pour myself a glass in the morning, after I’d dropped the kids off.

‘That was when I knew you didn’t have to be a homeless person sitting on a bench to be an alcoholic – it dawned on me that I had a problem.’

Joanna is far from alone in her routine. She is an example of the growing number of Britain’s so-called functioning alcoholics. Far from the stereotypical image, they are able to function in demanding jobs, or manage to be perfectly decent parents. They – and their loved ones – are often unaware of their problem.

‘The traditional alcoholic will drink to get drunk – even if it takes an obscene amount to get them there – so there’s no hiding their problem,’ says Dr Tiago Reis Marques, a psychiatrist at the South London and Maudsley NHS Foundation Trust and chief executive of psychiatric research centre, Pasithea Therapeutics.

While 75,000 Britons are diagnosed with alcoholism each year and receive treatment, it is estimated that 7.5 million people show signs of alcohol dependence: drinking is 'the most important part of the day' and they feel 'unable to function without it'

While 75,000 Britons are diagnosed with alcoholism each year and receive treatment, it is estimated that 7.5 million people show signs of alcohol dependence: drinking is ‘the most important part of the day’ and they feel ‘unable to function without it’

‘These people often end up with very chaotic, disastrous lives, and tend to be from less well-off backgrounds. But functioning alcoholics drink a lot as part of their daily routine. Typically they’ll have a bottle of wine over lunch, maybe a gin and tonic at teatime and then more at dinner.’

Functioning alcoholics may drink to reward themselves, when they feel unhappy or angry.

They will often go without drinking for a period, Dr Reis Marques adds, and will make a big deal of it, telling friends they’re ‘not drinking in the week’, when really, all they’re actually doing is fixating on the next time they do.

He says: ‘Over time, they develop a high tolerance to alcohol by doing this, and don’t feel intoxicated. But they are not drinking enough to suffer physical withdrawal symptoms when they have a day without drinking. It goes unnoticed because they can get on with their life without much drama, and friends or colleagues might be doing the same.

Alcohol facts

  • Roughly one in ten suicides in England are related to alcohol misuse, according to the latest NHS data.
  • The UK’s heaviest drinkers make up four per cent of the population but consume about a third of all alcohol sold. 

‘Meanwhile, they are at ever higher risk of developing liver disease, memory and mood problems.’

Since 1970, annual deaths due to liver disease have increased by 400 per cent – every day in the UK, it kills more than 40 people.

This is in stark contrast to other major killer diseases such as heart disease and cancer, in which the number of deaths have either remained stable or decreased. 

And experts say our relaxed attitude to what might be considered heavy drinking is mainly to blame.

Thankfully, for Joanna, help was at hand from a London-based clinic, specialising in intensive day therapy for patients just like her. 

Help Me Stop is one of a handful of services around the UK offering flexible rehab treatment to fit around functioning alcoholics’ busy lives.

Having become oversubscribed, it opened a second clinic last week – and The Mail on Sunday was granted exclusive access to talk to the patients.

Thanks to Help Me Stop, Joanna hasn’t touched a drink in a year. She says: ‘I joined Alcoholics Anonymous, and a friend I met there told me about Help Me Stop. During therapy sessions, they help us learn how to deal with stress and boredom and not to rely on that glass of wine.

‘I accepted I had an issue – a disease that needed treatment. And slowly, with the support of the therapists at the clinic, the urge to drink disappeared.

‘I can finally concentrate on things. I do Pilates and meditation regularly, and I feel like I finally have a clear head.’

Experts began noticing this new type of hidden alcoholic a few years ago. In 2019, Dr Iqbal Mohiuddin, a psychiatrist working in an addiction service in Bedfordshire, noticed between a third and a half of his patients were working in high-powered jobs where drinking heavily was socially accepted.

He says: ‘They’ve carried on for years this way, but suddenly they’re getting physical symptoms such as feeling sick in the morning, or perhaps a partner had had enough.’

While 75,000 Britons are diagnosed with alcoholism each year and receive treatment, it is estimated that 7.5 million people show signs of alcohol dependence: drinking is ‘the most important part of the day’ and they feel ‘unable to function without it’.

The pandemic may have worsened the picture.

Research published in November last year showed that 26 per cent of Britons had increased their alcohol consumption since the first lockdown, and the majority of the rise was seen in women.

Experts suggest this is due to the fact they were often responsible for the lion’s share of home schooling, which had to be juggled along with work commitments and household chores.

The study’s authors, from charity Drink Aware, found that 14 per cent of the nationwide sample of women were regularly drinking more than the Government-recommended maximum of 14 units (roughly a bottle and a half of wine) a week.

‘We’re seeing women who don’t think it’s a problem because they don’t drink in front of the kids,’ says addiction counsellor Sammy Manzaroli.

‘Then things get hairy when someone at the school gates smells alcohol on their breath, or they are pulled over on the way home from school for drunk driving. But to look at these women, you’d never think they’d have this problem.’

Another case in point is Melanie Jones, a 44-year-old PR executive from Dorset, who went from the occasional boozy client lunch pre-Covid to afternoon benders alone during the first lockdown.

‘It started when I was going to glitzy events a few nights a week and it was expected I’d drink a lot. Sometimes it would even help you make contacts if you’d bonded over a fun, boozy night,’ says the single mother-of-three.

‘Then, when lockdown started, I’d reward myself with a glass of wine for finishing home schooling at 4 o’clock. It helped cope with the loneliness of the day, managing with three teenage boys and a demanding job.

‘I’d be running around cleaning, cooking, tidying, working, getting everything done. But by dinnertime, I’d have polished off a full bottle on my own.’

With no visitors during lockdown, and her boys ‘happy as long as dinner is on the table’, her habit went unnoticed. Eventually, the alcohol took its toll on her mental health.

‘I started having suicidal thoughts,’ she says.

‘One night I felt so depressed, I remember thinking I wouldn’t care if I died tomorrow.

‘My kids were all asleep in their bedrooms, and I thought, ‘When they wake up, I’ll be dead.’ But I didn’t do anything, and in the morning I was so terrified by my thoughts I knew I had to get help.’

Melanie found Help Me Stop’s online rehab programme – which offers the same intensive schedule as the in-clinic model but via Zoom.

‘I didn’t even consider proper rehab,’ she says. ‘I have a career and three children to look after. I can’t be away from them for six weeks.’

Every night between December 2020 and April this year, she’d shut herself away in the spare room and log on for three to four hours of intensive therapy, while the kids were playing video games in the next room.

‘The change in me is remarkable,’ she says. ‘Before, my mind would be wandering during every conversation. I’d take the dog for a walk and I wouldn’t notice anything around me. Now I can fully engage in every aspect of my life.

‘I know I’ll be recovering for ever, but it’s worth it.’

Help Me Stop says its six-week treatment plan is unique, because patients can do a full set of group and individual sessions before lunchtime, or, if they wish, complete the therapy – a mix of cognitive behavioural therapy, other types of psychotherapy and meditation – via online evening classes.

Patients must have a finger-prick blood alcohol test and use a breathalyser before entering the clinic. Those taking part in online sessions have to complete a breathalyser test on video.

The treatment of alcoholism in the UK varies depending on the local area.

On the NHS, services prioritise those at risk of severe physical withdrawal – seizures, severe headaches and at risk of sudden organ failure. And even then, getting help is a postcode lottery.

A 2019 audit by the National Association for Children of Alcoholics revealed that since the beginning of 2018, 60 per cent of local councils had reduced addiction services for those with drug and alcohol dependency issues. Many turn to private clinics, but these facilities, experts say, are not set up to help functioning alcoholics.

‘Most of what’s available is only residential,’ says Mr Manzaroli, who is treatment director at Help Me Stop. ‘But this doesn’t work for patients with busy lives and commitments, so they just put it off and drink more and more until they get very sick.’

Dr Reis Marques agrees that the kind of treatment available in many clinics ‘isn’t well suited’ to functioning alcoholics.

‘A lot of it focuses on putting back together the pieces of your life that drink has ruined,’ he says. ‘Most traditional alcoholics will have lost a great deal of their livelihood. But functioning alcoholics don’t need to do this, generally, because they still have everything together. For them, it’s got to be about learning practical tools to help them cope with the stressors in their life that make them turn to booze.’

Once patients learn ways to cope with these triggers – such as breathing exercises or distraction techniques – they can begin to tackle the reason why they struggle to cope.

‘People start drinking to numb difficult emotions, like feeling not good enough or sadness, guilt or shame,’ says Mandy Saligari, psychotherapist and clinical director of Charter Harley Street clinic.

The six tell-tale signs that mean you might need help…

Experts say if you tick four or more of these boxes, you could have a problem.


  • Drink more than five units of alcohol (half a bottle of wine/three pints of beer) most nights every week
  • Reach for alcohol frequently when you feel sad, angry, guilty or lonely
  • Feel like you’ve achieved something if you go two days without booze
  • Prepare yourself for difficult or stressful situations by drinking alcohol
  • Think a lot about alcohol and when you will be drinking again
  • Feel anxious or depressed more than twice a week after a big night of drinking

‘There’s often a deep emotional problem underlying this, because it isn’t normal not to be able to sit with difficult feelings.’

But does that mean those of us who open a bottle after a stressful day are masking deep, emotional issues, too?

‘The difference is, for most of us, if we didn’t have that glass of wine we would cope,’ says Saligari. ‘However, these patients become very distressed if, after a difficult day, they couldn’t get access to alcohol. That’s a dependency – a marker of an addiction.’

Experts say functioning alcoholics’ drinking is usually triggered by difficult life events.

This rings true for 41-year-old Samantha Cole, a toy-shop owner from Barry, South Wales. While the mother-of-three had ‘liked a good drink’ since her late teens, the habit revved up after the breakdown of her relationship 13 years ago, leaving her alone with her toddler daughter.

‘When I became a single mum the reason why I drank changed instantly,’ she says.

‘Instead of it being at the pub every other weekend to have fun with my mates, it was to destress in the week while trying to work and look after my daughter.

‘I started opening bottles of wine at five or six o’clock, when I was getting her ready for bed, or before dinner if I was hungry and felt I needed something to keep me going.’

In 2017, Samantha met a new partner, got married and had two further children, Matilda, five, and Atticus-Fox, three. And as she struggled to juggle running a business with the children’s needs, the drinking ramped up.

‘It got even worse when my grandparents died. I started drinking three bottles every night and then falling asleep on the sofa by 7pm. But I’d always make sure I’d put the children to bed, and done everything I needed to, work-wise.’

She says her husband, who wasn’t a big drinker, unwittingly encouraged it. ‘He could see I would get sad or stressed and that drinking helped me, so wanted me to do whatever it took to make me feel better. It made his life easier.’

The death of her father last summer was a wake-up call.

‘He was a big drinker. It made me realise that if I didn’t stop now, I could get to the point where I’d never be able to.

‘And I started to think about all the things in my life that were making me unhappy, and how it was clear I was masking it with drink.’

With little to no support available on the NHS in Samantha’s local area, she sought help from another newly launched online programme for functioning alcoholics, One Year No Beer.

Treatment involves regular one-to-one sessions with an addiction specialist and unlimited access to thousands of fellow patients in online forums.

There is also a daily email providing patients with practical advice for managing triggers and resisting the urge to relapse.

Experts say, even for functioning alcoholics, this is often not intense enough, and recommend patients commit to a daily schedule of treatment sessions run by clinicians.

But for Samantha, it seems to have worked. She’s been sober just over a year.

‘I can finally do all the normal things I was missing out on,’ she says. ‘I can go to the gym, I can get a good night’s sleep, I can go to work meetings, I can take the kids to the cinema in the evening.

‘Before, I was a prisoner in my own home. As soon as I had a drink, I couldn’t drive so I didn’t go anywhere. My mantra used to be: life’s too short, drink the wine.

‘Now it’s: life’s too short, start living and start experiencing.’

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