Despite what you might see on TV or in movies, addicts aren’t all pretty much alike. As with any complex disorder, every person dealing with addiction has their own story (even if, yes, it’s often a pretty colorful one). And the differences go well beyond simple variations in substances or compulsions. Study the behavior and patterns of those struggling with addiction (and, often, another mental disorder in the bargain) and you’ll see that several common “styles” (for lack of a better term) emerge.
Check out the four profiles below: Maybe you’ll recognize your own pattern, or that of a loved one. If any of these look all too familiar, it’s time to seriously contemplate taking action, by seeking professional help or trying to change your behavior on your own.
The High-Functioning Addict
As the name implies, people who fit this profile are often able to keep up with many of their day-to-day responsibilities, maintaining the appearance that all is well despite their substance abuse and/or behavioral addiction. It often takes a while for their problems to catch up with them. For the High-Functioning Addict, “the concern is more about what’s going to happen [to them] next than what’s happening [to them] now,” explains Tom Horvath, PhD, a clinical psychologist and owner/president of Practical Recovery, a non-12-step drug rehab and alcohol treatment program in San Diego, California.
Many high-functioning alcoholics, for example, “appear to the outside world to be managing life well — they are skilled at living a compartmentalized life,” notes Sarah Allen Benton, a therapist in Ridgefield, Connecticut, and author of Understanding the High-Functioning Alcoholic. Yet, while this person might be, say, a great success at work, his or her personal relationships or finances — factors that probably aren’t obvious to outsiders — may be strained because of their using. Many of these folks “have common personality traits that help them maintain their external achievements while drinking problematically,” Benton says. For example, they tend to have an attachment to tangible measures of success (money, power, material goods) and perfectionistic tendencies, she says. The High-Functioning Addict is likely to be goal-oriented and feel the need to prove him or herself; often they have an outgoing personality, too.
The Below-the-Radar Addict
Like the High-Functioning Addict, people who fit this profile may not be “having obvious problems that are related to addiction,” Dr. Horvath says. “They’re smart enough and diligent enough to hide it and mitigate risks — by not drinking and driving, for example — and prevent problems.”
Deep down, though, “a Below-the-Radar Addict may be quietly self-medicating anxiety or depression, but the person has enough resources or coping skills to evade detection for a while,” says Michael Weaver, MD, medical director of the Center for Neurobehavioral Research on Addiction at the University of Texas Health Science Center at Houston. For some people with this pattern, trouble may not occur until they do something socially inappropriate that causes embarrassment. Or the first sign of a substance abuse problem may show up on a liver enzyme test or another health screen.
The Shape-Shifting Addict
Rather than sticking with one vice or habit, the Shape-Shifter tends to bounce from one compulsive behavior to another over time. He or she might kick an alcohol abuse problem then move on to a smoking addiction or overeating. Others may be opportunistic users who go with whatever substance is available. In other words, the Shape-Shifting Addict substitutes or replaces one addictive behavior for another in the search for an interesting high, Horvath says.
A primary underlying drive may be to find insulation from the stresses of life. “A Shape-Shifter is seeking new ways to suppress negative emotions and may have suffered childhood trauma or have a lot of volatility in his or her life that manifests itself in this way,” Weaver notes. The trouble is, the person is using various substances and/or unhealthy behaviors to self-medicate unpleasant emotions or deal with difficult people in their lives, rather than finding better ways of coping.
The Up-and-Down Addict
Someone with this pattern has a tendency to overdo it, perhaps by drinking excessively, bingeing on food or drugs or going on a spree of gambling, video gaming or another compulsive behavior. Typically, this continues for a while until the individual enters a period of abstinence during which he or she works harder than usual and becomes hyper-responsible and conscientious. “A good portion of [people with this pattern] feel guilt or regret over their lack of self-control,” explains Horvath, so they try to compensate by being extra good.
The trouble is, the pressure to be on their best behavior “sets them up to binge again because they need a break,” Horvath adds. “This bipolar pattern of use ends up being exhausting.” Developing more moderate, realistic expectations of themselves and healthier ways to cope with the pressure in their lives can begin to help people with this pattern overcome it and find their way to a sustainable recovery.