Diary of a functioning alcoholic

They're smart, successful professionals who never miss a day's work - the very opposite of the image of the problem drinker. Natasha Courtenay-Smith meets three upright young women who thought alcoholism would never happen to them

Before she fell pregnant in 2000 Olivia McMahon had a reputation as a bit of a party girl. On a night out she was always the first to the bar and the last to leave, and was proud of her ability to throw back more tequila shots than any of her peers.

'I was always up for getting really drunk - I had been since my teens,' says Olivia, now 37, a successful food photographer. 'I didn't think I was any different to my friends or my husband. We all liked socialising and having a good time, and I wouldn't have even considered that any of us was drinking too much. Yes, I did throw up from time to time, and suffered from memory loss after a big night out, but doesn't everyone? I could still drag myself into work in the morning, even if I did have a stinking headache, so I couldn't see what the problem was.'

Even when, following the birth of her daughter Chloe, Olivia began to drink during the day, too, she wasn't concerned about the amount of alcohol she was consuming. 'I had a few friends with babies of the same age, and we'd all get together for lunch, during which I'd inevitably crack open a bottle of wine,' she recalls. 'I'd end up plastered by 3pm, and would open another bottle of wine in the evening when my husband got back from work. The last thing on my mind was that I had a problem - I was just making the most of my maternity leave. I'd stopped breast-feeding by then, so I wasn't worried about my daughter.'

Olivia's case may be extreme but these days she is far from alone. According to the Office for National Statistics, almost a quarter of adult women report drinking five days or more per week, and recent NHS figures state that a fifth of women drink more than the recommended number of units at least once a week. Even those of us who have grown out of excessive bouts of binge drinking seem to have a bottle of wine permanently chilling in our fridges and think nothing of pouring ourselves a large glass to accompany our dinner.

Yet how many of us realise that alcohol affects women's bodies differently to men's, and can increase our risk of cancer, digestive problems and coronary heart disease? The number of women in Britain dying from drinking has almost doubled since 1991 to just under 3,000 in 2005, with women aged between 35 and 54 the fastest-growing group of victims. High-profile deaths related to alcohol include Sally Clark, the solicitor wrongly jailed for murdering her two sons, and the ex-MP Fiona Jones, who died last year aged 49. She turned to drink to deal with the stress of working in the House of Commons and slid into full-blown alcoholism after losing her seat in 2001.

For Olivia, returning to work meant that her drinking escalated. 'I was being pulled in so many different directions that I couldn't do anything properly, and alcohol was the only way I knew to relieve the stress,' she says. 'We'd often have bottles of wine and champagne on photo-shoots, and I'd have a glass while I was working. No one said anything as they all thought I was just game for a laugh. At home I drank more than ever, too. I could easily polish off a bottle of wine on my own, and would frequently have a third of a second bottle as well.'

By the time Chloe was two Olivia was out every night drinking heavily with friends, while her husband looked after their daughter. He eventually kicked her out of the family home. Still, when he insisted she had a problem she wouldn't listen. 'In my mind I didn't fit the mould of the alcoholic. I didn't keep vodka in my sock drawer and I didn't drink first thing in the morning.'

So how much alcohol is too much? The Department of Health recommends that women drink no more than 14 units of alcohol a week, and no more than three units in any one day (a 175ml glass of wine at 13 per cent is 2.3 units; a measure of spirits is one unit). After an episode of heavy drinking it is advised that you refrain from drinking for 48 hours to allow the body to recover. But William Shanahan, the medical director at the Capio Nightingale clinic, which offers treatment for addiction problems, says such guidelines are confusing.

It is not possible to state, he says, a single tipping point at which heavy drinking can be called alcoholism. 'It's important to remember that all alcohol is a poison, and that our bodies are only able to metabolise one unit an hour,' he says. 'Anything over that will damage your body. Most people hate the term "alcoholic" because they don't see themselves sitting on Hungerford Bridge with a brown paper bag. It's much more helpful to think of it in terms of "harmful drinking" and "dependent drinking" rather than simply as alcoholism. Drinking is harmful if it causes a problem in any area of your life. If, for example, your character changes for the worse after a few glasses of wine, you might not be dependent on alcohol but there is a problem and you do need to look at the way you drink. If it affects your work, leads you to have unsafe sex or results in mental problems such as depression, you definitely need help. Dependent drinkers find that life is not possible without a drink, and they also experience withdrawal symptoms or cravings for alcohol. This is equally a problem that needs medical help.'

For Olivia McMahon help came in 2004 when she finally went into rehab at the Life Works treatment centre, after her husband stopped her seeing her daughter. 'I hadn't been able to accept I was an alcoholic, but the truth finally hit home when tests showed my liver function was seriously impaired,' she says. 'By the time I came out I was not only clean but was also determined never to drink again. My marriage was beyond repair, so my husband and I sold our house and I was able to buy myself a small flat. He insisted on Chloe continuing to live with him until I'd proved I was fully recovered,' she says, 'and 18 months ago Chloe finally moved back in with me.'

According to Frank Soodeen, a spokesman for Alcohol Concern, it is women in professional households who are the most likely to drink regularly and to excess. 'Studies have shown that professional women use alcohol as a prop to cope with exhaustion, anxiety, isolation within a family setting and possibly feelings of "loss of role" when children leave home,' he says. 'Women also drink to deal with the stress created by having to balance home obligations and intense competition at work.'

That is certainly the case for Georgina Lucas, an advertising executive who insists that within her work environment it is normal to manage stress using alcohol. 'My job involves flying back and forth across the Atlantic up to four times a month,' says Georgina, 34. 'I negotiate deals that are worth millions to my firm. I live in a state of permanent jet-lag, dealing with international clients who call me on my mobile any time, day or night. Even when I'm at home I'm up at 6am, in the office by 7am and spending all day in and out of incredibly stressful meetings.

'I drink to help me cope with the demands of my job, and to put me to sleep at night. Because I'm constantly changing time zones I end up drinking around the clock and spend a lot of my time mildly drunk. I can't see when I'll stop drinking as I'm single and not about to settle down any time soon. Alcohol and my job come hand in hand. I need to drink in order to cope, and to sleep. I don't even think about what effect alcohol could have on me in the long term; I don't see the point in worrying about the future when I've still got the now to get through.'

Although not surrounded by the stress of a corporate environment, 28-year-old Ruby Holmes also has a troubled relationship with alcohol. She began drinking heavily at university to mask the insecurities she felt about her body and looks. 'As a teenager I suffered from bulimia, and just looking at my reflection in the mirror would make me burst into tears,' says Ruby. 'I discovered alcohol when I got to university in Cardiff, and as soon as I had my first drink all my low self-esteem melted away. From then on I started drinking every night - I could easily polish off a bottle and a half of wine in one sitting. I also used to go to the student union to have a pint at lunchtime.

'I began to use drink to be liked and to boost my confidence. It was as though I'd started living a double life. Sober, I was quiet, introverted and frumpy. Drunk, I was fun-loving, extrovert and wore skinny jeans, miniskirts, vest tops and strappy dresses. I was able to flirt with men, which I could never do sober.'

Although Ruby found work after university, as an independent documentary-maker, her drinking slowly began to catch up with her. By the beginning of 2006 she'd sunk into a chronic depression. 'By this point I'd taken to drinking cheap vodka as well as wine at night, and in the mornings I'd wake up full of anxiety and self-loathing, with a sense of dread in my stomach,' she says. 'I could hardly work at all because I constantly had a hangover, and what with having to pay rent on my flat I was mounting up huge debts. By last summer I was drinking in the daytime, too - usually cheap vodka. Everything good about my life had fallen away and alcohol was the only thing I had to keep me going.'

Last year, realising she had a problem, Ruby attempted to go cold turkey. After experiencing severe withdrawal symptoms, including hallucinations and the shakes, she called an ambulance and was admitted to hospital with severe liver necrosis caused by alcohol abuse. She stayed in hospital for a week and was told that unless she stopped drinking she would die.

Recovery has been far from easy. 'I've been given anti-depressants and had counselling, but staying away from booze initially felt like a constant battle,' she says. 'None the less, I've managed to stay sober ever since, and it's as though a mist has cleared from in front of my eyes. My depression has vanished and, thanks to counselling, my body image has improved.

'Without alcohol I am ambitious and look to the future. I now look at all my friends, who still drink heavily alongside holding down full-time jobs, and wonder if they know the damage they could potentially be causing themselves. I'm just grateful I managed to stop drinking before it was too late.'

source: Telegraph