If you are married to someone with an alcohol use disorder (AUD), you’re familiar with some, if not all, of the symptoms that come with the disease:
- Drinking more or longer than they plan.
- Trying to cut back on drinking or stop drinking entirely, but being unable to.
- Spending a lot of time drinking or being hungover.
- Wanting a drink so badly that they couldn’t think of anything else.
- Drinking to the point that it interferes with work, finances, or family.
- Drinking even though it causes major life problems.
- Drinking instead of doing things they used to enjoy.
- Getting into dangerous situations as a result of drinking.
- Experiencing physical or mental health problems due to drinking.
- Needing to drink more than usual to get the same ‘buzz.’
- Feeling withdrawal symptoms when they went ‘too long’ without drinking.
According to the fifth version of the Diagnostic and Statistical Manual of Metal Disorders (DSM-V), your spouse need only have two of these symptoms to be diagnosed with an AUD. Up to three symptoms means their AUD is mild. A moderate AUD includes four to five symptoms, and a severe AUD involves six or more.
Most of your energy has probably gone toward helping your spouse manage their symptoms or to try to get them into detox or rehab. But it’s likely that you haven’t thought much about yourself other than to ask, “What can I do?” There are ways to help your spouse while also helping yourself so that you both can be healthy and happy.
You’re Not Alone
In 2014, 12.9% of the United States adult population (10.6 million men and 5.7 million women) lived with an alcohol use disorder. In the same year, 91.5% of the US adult population was married. It only stands to reason that the majority of that 12.9% was also married.
When coping with your spouse’s AUD seems impossible, remember that you’re far from the only one, that there are millions of other men and women in the same position. Some may be struggling, but others have found ways to cope and live happily together — and so can you.
Understanding alcohol use disorders
There are many factors that go into developing an AUD, including:
If your spouse is related to someone with an AUD, that could be contributing to their problems with alcohol. Studies have shown that differences in 51 different chromosomal regions can lead to an AUD later in life or increase the risk of developing one.
Situations like difficulties at work, unemployment/underemployment, loss of a friend or family member, etc. can initially lead someone to drink. Once they begin to associate drinking with stress-relief, long-term drinking could set in, causing norepinephrine (a chemical that increases feelings of anxiety, raises blood pressure, and heart rate) levels to spike in the brain. Thus alcohol becomes a necessary stress-reliever.
When they began drinking
Studies have shown that almost half of people who began drinking before age 14 went on to develop an AUD by 21. Only 9% of people who began to drink after 21 did.
Depression, anxiety disorders, bipolar disorder, and schizophrenia are all common in people with AUDs.
If your spouse fits any of these criteria, that may help you to understand why an alcohol use disorder is affecting your family.
How different genders deal with AUDs
Alcohol abuse is much more common in men than in women, and it affects them in different ways. Being able to drink a lot is seen as a sign of masculinity in much of the world. It also brings out different characteristics, such as dangerous driving, violence against both men and women, and giving them an excuse to ‘defend their honor’ if such an occasion presents itself.
Other men who have been taught not to show their feelings may become emotional drunks. They may cry or express love or regret.
On the other hand, women are more vulnerable to addiction than men, and they become addicted more quickly. When they enter treatment, their addictions are generally more severe, and they have more medical and psychiatric symptoms than men do. They have also suffered more social consequences as a result of their AUD.
Whether your spouse is male or female will help you to understand the specific dangers and co-occurrences of their AUD.
Dealing with denial
Many people with AUDs will have difficulty admitting they have a problem. This is normal. Substance use disorders (SUDs) have such stigma in today’s society and people with SUDs want to believe they’re in control of their life. Admitting to an AUD would upend the mythology they’ve created for themselves.
This mentality is especially common with ‘high-functioning alcoholics.’ Because they don’t hit the same sort of ‘bottom’ that others with AUDs have (losing their jobs, place to live, financial security, etc.), your spouse may not be able to see that they’re in a downward spiral.
Denial can also be something you deal with, too. Thinking that your husband or wife doesn’t have a problem because they go to work every day, or that they’re drinking because of external circumstances that will soon pass (despite constant drinking) is a way of refusing to deal with the real situation. Being patient with yourself and open-minded to the symptoms of an AUD can help you face the truth.
In short, denial is likely to occur on both sides of your marriage. It’s normal and the more you can plan for it, the better.
Looking into your spouse’s situation
Even if you know or suspect that your husband or wife has a problem with alcohol, it’s important to know the scope of the problem itself. Look at the list of AUD symptoms at the beginning of this article and determine how many of them your partner has so you can get an idea of the severity of the problem.
It’s also possible that your spouse may be a ‘high-functioning alcoholic,’ or someone with an AUD who can still excel at work, provide for their family, and that their drinking only affects themselves in superficial ways (hangovers, etc.). Since they seem to be put together from an outside perspective, it can be difficult for them (or you!) to see they have a problem. Try to be impartial when looking at the symptoms of AUDs if your spouse seems to fit this profile.
What’s happening in your house?
When you’re married to someone with an AUD, your relationship will often come second to their relationship with alcohol. Emotional connections can be difficult because communication about your spouse’s alcohol is either implicitly or explicitly not allowed. AUDs could lead your partner to lie or fight with you about their use, and your sex life could also suffer.
Once you realize that your spouse has a problem with alcohol, you will probably try to cover for their behavior or make excuses to others if your partner’s level of drinking is noticed. This can cause you to isolate yourself from friends and family, so they don’t notice your troubles.
There are usually financial problems as drinking increases, either from spending excessive amounts on alcohol or on making reckless purchases while under the influence.
Codependency, or unhealthily sacrificing your own needs in order to react and tend to someone with a substance use disorder in the hope of receiving positive validation, is also common in households where AUDs are present. You are probably suffering a great deal of mental stress and are using healthcare services more often.
Perhaps all of these exist in your home, or maybe there are only a few. Either way, there is likely to be a point where confronting your spouse becomes necessary.
Confrontation without conflict
When you decide it’s time to talk to your spouse about their drinking problem, there are a few things to keep in mind:
Don’t have any sort of conversation while you or your partner is under the influence.
This will only impede your ability to communicate and can result in frustration instead of understanding. On the other hand, if your husband or wife is hungover, remorseful, etc., it might be a good time to talk about the negative consequences of their drinking.
It may be hard, but come to the conversation from a place of compassion and empathy.
Remember that an alcohol use disorder is a disease, not a character flaw in your partner.
Try to address the situation in terms of how you feel their drinking is affecting you and others without making accusations.
For instance, you might want to address facts about what particular episodes resulted in without saying what they should do instead or try to self-diagnose your partner.
Think of this conversation as planting a new idea in their mind.
It may take a while for them to process or accept their disease. They may become defensive or angry. If this happens, remember that anger comes after denial in the stages of acceptance and give them the physical or emotional space to process this new emotion.
Above all, be patient.
This may be yet another conversation about their drinking, or it may be the first time you’ve talked openly about it. Either way, your spouse will probably feel apprehensive about it.
If you don’t feel like you can come to your spouse with this mindset, you think someone else in their life could do it better or that your spouse may be open to listening to someone else, that’s okay. The important thing is that your partner has a productive conversation about their AUD with someone who cares about them.
Help your spouse help themselves
If your husband or wife is open to getting help, their first step is to go to a therapist or doctor who can best diagnose them and recommend a course of treatment. There are also many types of meetings your partner can attend (Alcoholics Anonymous, SMART Recovery, or Women for Sobriety). Some even have ‘open’ meetings that you can attend with them.
Attending hospital follow-up sessions and self-help meetings has been shown to increase the outcome of a spouse’s recovery significantly, so your support makes a big difference in helping them succeed.
In the course of all this change and partner-centered care, you have to remember to take care of yourself, too. When using, people with AUDs often forget how important their relationships with others are. You have probably felt this lack in your own life. Your partner’s treatment will focus on improving their relationship with you, but there are things you can do to help yourself:
- Just as there are self-help groups for your spouse, there are groups like Al-Anon that are specifically for friends and family members of those with AUDs.
- Behavioral Couples Therapy for Alcoholism and Drug Abuse (BCT) can be helpful for you and your spouse to rebuild your relationship. This type of therapy is fairly intensive, requiring a recovery contract, daily ‘trust discussions,’ participation in self-help meetings, and urine screenings. However, it also focuses on repairing communication skills and building positivity and has been shown to improve relationships by about 95%.
- Attending therapy with your partner can absolutely be helpful, but if you feel that you could benefit from individual therapy, it’s more than okay to pursue that, too. While your partner may have a disease, you’ve been through a lot and deserve a space of your own to work through those issues.
Knowing when to leave
Being married to and living with someone with an AUD is assuredly taxing. There may come a time when the costs outweigh the benefits. For instance, if:
- Your spouse refuses to seek treatment.
- Your spouse is emotionally or physically abusive.
- Your own mental or physical health is suffering.
- Your spouse has incurred legal or financial burdens that you cannot bear.
- The relationship has broken down to the point of disrepair.
The choice to leave any marriage is difficult, and only you can decide if staying or leaving is right for you. But consider your wellbeing when making that decision, in spite of any internal or external pressures you may feel.
Life after alcohol
If your spouse enters treatment, prepare yourself for the idea that life will not go back to normal right away for either of you. Even if you choose to leave your marriage, recovery is a process that takes time. However, there are resources and methods to help both of you deal with the alcohol use disorder that has affected your marriage, all of which will lead you to a happier, healthier life.
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