Living with an Alcoholic

Families often experience repercussions from a loved one’s alcohol use disorder. One family member’s heavy alcohol use can destroy the fundamentals of the family, sparking feelings of shame, guilt, anger, fear, grief and loneliness.

Alcohol addiction can consume people, causing them to lose sight of their familial responsibilities. Spouses often pick up the slack and endure the psychological effects, including anxiety and depression, of living with someone with an alcohol addiction.

A 2016 study published in the Industrial Psychiatry Journal explained that an obsession with drinking causes alcoholics to forget about their relationships and the needs of their loved ones. Laura Lander, assistant professor at West Virginia University’s Department of Behavioral Medicine and Psychology, agrees.

Male alcoholics contribute to a stressful and traumatic home environment, plaguing their wives with anxiety disorders, depression, neuroticism and low self-confidence.

Earlier research showed that wives of alcoholics exhibited negative emotions because of their partner’s alcohol problems. These emotions are detrimental to the wives and the family unit by lowering self-esteem and reducing the overall quality of life.

Harmony Rose, author of “Married Under the Influence,” had common preconceived notions of what an alcoholic was before alcoholism devastated her marriage. Her husband had a stable career, and he never missed a day of work. He was a social drinker who got drunk mostly on weekends. When he occasionally drank too much during the week, she made excuses for it.

Rose’s marriage took a back seat to her husband’s disease. For the majority of their 17-year relationship, her husband was committed to alcohol. Before he attended rehab and overcame addiction, she said the drinking took over his life. Drinking beer escalated to drinking wine and beer at the same time. When that wasn’t enough, he turned to liquor and took shots.

“We would argue and fight; it was a broken record for many years,” Rose told DrugRehab.com. “Our family dynamic was sick and dysfunctional,” she said.

Lander described substance use disorders as progressive family disorders, explaining that the family progresses through the disease with the alcoholic.

She also says a parallel sickness can simultaneously develop between the alcoholic and family members. The family becomes tangled in their loved one’s alcoholism. Family members are negatively affected by the alcoholic’s compulsive behavior.

“Ten months into the relationship, he would go to the casino, gamble hundreds and lose,” said Rose. “Finally, he lost a whole paycheck — thousands of dollars. We could not make our mortgage. We had no food and three kids.”

But alcoholism isn’t an unbeatable disease. The psychological effects of alcohol abuse on families can be treated. As an alcoholic recovers from addiction, family members can learn to make amends, communicate effectively and rebuild damaged relationships.

Experts often view the wives of alcoholic men as codependents, according to a 2008 study published in the journal Family Relations. The authors defined codependent wives of alcoholics as women who adopt a continued preoccupation with the alcoholic’s behaviors as a way to feel safe, increase self-esteem and obtain a sense of identity. “The alcoholic is typically underfunctioning, so the family will begin to overfunction to take on the duties and roles of the alcoholic,” Lander said. “The family gets attuned to the alcoholism in an effort to stabilize the family system.” In an interview with DrugRehab.com, addiction expert Dr. Kenneth Leonard from the State University of New York at Buffalo said he did not agree with the term codependency. “Behaviors such as calling an employer to excuse a spouse’s hangover minimizes the real issue that the family faces: A loss of a job may be a critical element to a family,” Leonard said. “[The term] ‘codependence’ neglects the fact that people have to choose between a bad outcome and a worse outcome.” Lander said partners can protect children from unstable environments, but the children may end up blaming the wrong person for family issues. In their eyes, the alcoholic parent was either always sleeping or never around. On the other hand, the sober parent was always full of anger and frustration. In Rose’s case, her husband’s youngest daughter always protected her father, justifying his actions and denying his alcoholism. When Rose published her book, her stepdaughters saw the situation in a new light. Clueless to their father’s alcoholism, they did not realize the extent of the problem. National surveys from 2002 and 2007 found that nearly 7.3 million minors had a parent with an alcohol problem. Rose’s family did not openly communicate about their patriarch’s alcoholism until they read the book. She said that she lied to her children to shield them from their father’s addiction. “Addiction should not be on the children,” Rose said. “They already suffer enough by not having their dad around.”

Determining whether your partner has an alcohol addiction can be tricky because he or she may be a high-functioning alcoholic. Alcohol affects people differently, and high-functioning alcoholics may seem to have a grip on their lives as they drink in secret. It took several years for Rose to realize that she was enabling her husband. She would sit with him as he drank. At times, she would purchase alcohol for him. But once she started reading about alcohol use disorders, she understood that his behavior was not normal. Every time she asked whether he was an alcoholic, he denied it. When she would catch him drinking excessively, he would admit to having a problem but deny it weeks later. “His addiction to alcohol caused him to make up excuses for everything,” Rose said. “He would be fine for a little while but then would drown in alcohol again. It became a pattern.” Family members can’t diagnose a loved one with alcoholism based on one or two events. The symptoms and warning signs appear over time and contribute to a pattern of unhealthy behavior.

Warning Signs

Lander explained that alcoholism progresses more slowly than an intravenous drug addiction. People who inject cocaine can become addicted in less than a week. An alcohol use disorder can progress over a decade. “It creeps up on people, especially if you are living with an alcoholic,” Lander said. Guidelines from the National Institutes of Health define at-risk drinking for men as having more than four drinks on any day or more than 14 drinks per week. At-risk drinking for women involves more than three drinks on any given day or more than seven drinks per week. According to the National Institutes of Health, 25 percent of people who exceed recommended drinking limits have an alcohol use disorder, and the remaining 75 percent are at increased risk of developing an alcohol addiction and other complications.

What to Expect From an Alcoholic

Rose said alcoholism robbed her husband of his family. He was physically present but never emotionally there. She described her husband as a shell of himself, one who would compromise his family’s safety. She said alcoholics could never be trusted because they will always lie to get what they want and partners of alcoholics could expect blame, lies, betrayal and infidelity. “They are very dysfunctional and can be very abusive,” Rose said. “They also tend to shift blame to the person closest to them.” she said. Leonard explained that a lack of consistency in behavior creates the unpredictability seen in alcoholics. They may display positive and negative behaviors, so their loved ones never know what to expect.

The Alcoholic’s Perspective: “It’s Not Really a Choice”

Alcoholics process emotions differently from people without an alcohol use disorder. They misconstrue facial expressions and mannerisms, and they show extreme behaviors such as impulsivity or aggression. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol interferes with pathways in the brain, affecting mood and behavior. Prolonged exposure to alcohol forces the brain to adapt to the presence of alcohol, which results in cravings. Lander characterizes alcoholism as a brain disorder. She explained that alcoholics do not function normally or make rational decisions. “Alcoholism is about survival; an alcoholic needs his alcohol to survive. It’s not really a choice,” Lander said. When his youngest daughters counted 19 bottles and cans from one night’s drinking, Rose’s husband decided he was going to start drinking outside in the shed or at bars so the children would not know the extent of his alcohol use disorder. He didn’t realize the harm that he caused to the family until after rehabilitation, therapy and support group meetings.

Every situation is different. Many spouses don’t want to abandon their loved one in a time of need. Alcoholism is a disease, and support from family members is crucial for people in recovery. Family members can encourage and inspire loved ones to seek treatment, but they shouldn’t sacrifice their own health or safety. “People should leave when safety cannot be ensured, in cases of physical violence, or when the spouse is becoming clinically sick from their spouse’s addiction, such as severe depression or suicidal thoughts,” Lander said. Constant exposure to domestic violence toward a parent may induce learning and behavioral problems in children. A 2013 study published in the journal Social Work in Public Health highlighted that children living in the home of a person with a substance use disorder tended to shoulder parental responsibilities, which robbed them of their childhood. Rose described the emotional abuse that she and her children experienced as traumatizing. “It does not leave you the way bruises do,” Rose said. “You start to believe what they say, and they need somebody to blame.” Lander explained that alcoholics drink to numb their feelings, and they often deny having a drinking problem when confronted by a spouse. Alcoholics will do anything to divert attention from their own behaviors. However, Bennett also noted a list of reasons why people would choose to stay with their alcoholic partner, factoring in the fate of the children, their financial situation and the social stigma of divorce. Deciding when to leave an alcoholic can be difficult. Leonard agreed that every situation was different, but he maintained that a threat to physical safety demanded serious consideration to leave the relationship.

Wives of alcoholics resort to emotional and problem-focused coping strategies to deal with their husbands’ alcohol use disorders. According to a 2016 study published in the Industrial Psychiatry Journal, wives demonstrated five behaviors: attack, withdrawal, protection, acting out and safeguarding interests of the family. The study observed three methods of coping, including engaged coping, tolerant coping and withdrawal coping.

Engaged Coping

Engaged coping is the active participation in the husband’s alcoholism. Wives will resort to a range of assertive, controlling, emotional and supporting behaviors to alter their husbands’ drinking habits. Yet the wives become slaves to their husband’s alcohol problems. “The spouse becomes preoccupied with the alcoholism, developing an obsession with the disease,” Lander said. “They try to be helpful [and] think they are controlling the addiction, but they are not.” Engaged coping can be emotionally draining. But to some spouses, it boosts their self-esteem and provides a sense of satisfaction to believe they are helping the alcoholic and their family. The 2016 study found that 93.4 percent of the participating wives of alcoholics chose to sit with their husbands and talk about the problem, while 93 percent pleaded with their partners to quit drinking. Seventy percent argued as an engaged coping skill.

Tolerant Coping

Tolerant coping is comparable to self-sacrifice, according to the study authors. The goal of tolerant coping is to minimize arguments. Spouses often feed the alcoholism by making excuses for their alcoholic husbands or giving them money despite knowing they will spend it on their addiction. Tolerant coping was less common than engaged coping in the study. Only 3 percent of wives supplied money to their alcoholic partner, and 6 percent made excuses for their partner’s alcoholism.

Withdrawal Coping

About one out of four wives surveyed in the 2016 study used withdrawal coping techniques. This form of coping involves avoiding the alcoholic and engaging in other activities. Tolerant coping and withdrawal coping contribute to poor drinking outcomes. They also negatively affect the family, increasing depression rates among nonalcoholic wives. According to the study, 70 percent of wives surveyed developed anxiety because of their husband’s alcoholism, 60 percent reported being mentally disturbed and half were frustrated by their situation. Yet nearly half of the wives never took their frustration out on their children, and 75 percent never ignored their children. Rose said wives of alcoholics should find healthy ways to cope by seeking support from others. “Don’t isolate,” she said. “Don’t be afraid or ashamed because it is not your fault. The alcoholic will tell you it is; they are manipulative. Reach out to someone, anyone. Don’t suffer in silence because it gets worse.”

Recovering from an alcohol use disorder is a lifelong process.

While alcoholics develop a tolerance to alcohol, family members build a tolerance to the unacceptable behaviors associated with problematic drinking, according to Lander. She emphasized that family members should understand alcoholism is the brain disorder behind the negative behaviors.

Rose said alcoholism is a disease that alters an individual’s brain chemistry and pushes a person to behave in ways that harm their families.

“When you look at an alcoholic, you have to separate the disease from the person,” Rose said. “Who they are is what the disease created them to be, it’s not the person they are underneath. It’s emotionally crippling — just as much for the family as for the alcoholic.”

These steps differ from an intervention. When a person’s alcoholism progresses and he or she refuses treatment, close friends and family may need to guide their loved one toward recovery.

In 2007, Leonard led a study that explored the role of marital therapy in treating alcoholism. He found that behavioral couples therapy helped reintegrate the alcoholic back into the family.

Involving both partners in treatment helped the alcoholic maintain sobriety and helped repair the relationship.

“Because relationships can create lots of stress and lots of emotional upheaval, repairing the relationship is critical to minimizing the emotional offset that can lead to a relapse,” Leonard said.

Alcohol Use Disorder Treatment Works

During the first 10 months of her husband’s rehab, Rose’s life was a nightmare. The abuse and the lies worsened, and he cheated on her. He was sober but not recovering.

“Rehab opens your eyes, and when you lose the alcohol glasses, it’s like coming out of a basement after a tornado hits,” Rose said. “You see all the damage and destruction around you. That’s what an alcoholic does to a family.”

The turning point came when her husband decided to focus on his recovery program and their marriage. They were able to rebuild the trust in their relationship and work on healing together.

Before he committed to recovery, Rose’s husband was oblivious to the family’s problems. After he committed to sobriety, her husband became more physically and emotionally present during family crises.

“It’s an amazing difference when you get sober and you recover,” Rose said. “You get your life back, you actually get to be present for the people that you love. You get to be there for everybody else, and you get to be there for yourself.”

Al-Anon and Other Support Groups

Al-Anon Family Groups provides a platform for the friends and family of an alcoholic to share their experiences and connect with other people going through similar situations. Al-Anon meetings typically start with a reading of the 12 Steps of Al-Anon, which aim to help people heal from the effects of the alcoholics in their lives.

Friends and family can also support the alcoholic by taking on responsibilities that prevent the alcoholic from getting treatment, such as work, child care and chores.

The person in recovery will require additional support after treatment and therapy. Loved ones should remain invested in the alcoholic’s recovery by asking about coping strategies for avoiding triggers. Friends and family members should also consider abstaining from alcohol consumption around the person, even in social situations.

Living with an alcoholic is challenging, and only you know how much of the addicted behavior you can take. The important thing to remember is that recovery is possible. Your family can heal.

Take care of yourself, and get your partner into treatment. Your loved one’s addiction is not your fault. You can’t control the disease, but you can offer your love and support.

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.