Someone I grew up with drank (still drinks) a lot. And over the years, I’ve struggled with her alcohol use. Year after year, the incidents around her drinking have piled up. There was the time she was laid off and spent the next several years living rent free in a home her parents owned, spending her days drinking and watching TV, rarely bothering to get dressed. There was the night of her brother’s wedding, where she was found vomiting in the bushes outside the reception site after overindulging in the free alcohol. And there were the trash cans full of empties each time she’d visit me. To this very day, I’ve never seen her go twenty-four hours without drinking enough alcohol to knock my moderate drinking ass to the floor. Yet I wondered for years: is she an alcoholic?

I mean, sure when you put it like I just did, things look bleak. But that ignores the other part of the picture: the one where she has a job, a long-standing marriage and kids. The one where she’s never had a DUI or missed a school play or failed to get a project done for work on time. She’ll see herself in pictures and say with a laugh, “Look at me with a beer in my hand all the time. People will see these and think I’m an alcoholic!” Maybe she’s been right in the way she sees herself: as a fun loving girl who enjoys a good drink, no real harm done. Each time the thought “maybe she’s an alcoholic” flashed across my mind, it was inevitably followed by pangs of doubt and guilt.

How could I know? After all, look at the official criteria for alcoholism as set out in the current edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), that Bible of mental health issues. Like most mental health symptoms, they’re vague, and they rely largely on what the person in question is feeling and thinking, rather than what we outside observers may see. I mean how was I supposed to know whether my friend needed more alcohol than she used to to achieve the “desired effect?” When I’ve looked at my trash can over the years, the number of bottles and cans I see has remained at a pretty consistent figure of “a lot.” But was that everything? If she were an alcoholic, she’d probably hide the real number. And I know she drinks more than I want her too, and more than her family wants her to, but how could I know if she wanted to cut down on how much she drank? (By all appearances, she doesn’t.) And how would I know how much she “intended” to drink and whether what she drank was more than that?

For nearly my whole life, I was indecisive about how to approach her drinking. I felt stuck because I believed that how I acted would depend on whether or not she had a diagnosis that I could never be sure she had unless she embraced it herself. In the wake of discovering my husband’s sex addiction and working through my own issues around that, I’ve realized that it doesn’t matter whether she is “really” an alcoholic or someone who just likes to drink a lot and doesn’t want to quit. The way that I need to respond to her is the same in either case. It’s not okay for me and for my own recovery to take care of her or try to control her, whether or not she’s “really” an alcoholic. As a codependent, I am certainly capable of responding to non-addicts with the same unhealthy behavior that I do addicts. So, I’ve put aside the question of whether or not she fits a diagnosis, I can act as if she does. Because whether or not she does, my approach is the same: use the tools I’ve gained in recent years and work through my own issues around her drinking.