Alcoholism has been front and center in the news lately. As have countless stars before her, Whitney Houston succumbed to a lethal combination of prescription sedatives and alcohol before drowning in a hotel bathtub. George Hugeley V, the UVA lacrosse player convicted today for the murder of his ex-girlfriend Yeardley Love, kicked down the door of her room in an alcohol-fueled rage and is alleged to have smashed her head against the wall, leaving her to suffocate in her own blood-soaked pillow. Stories like these mislead us into thinking that alcoholism is always accompanied by drama and dissipation. Not necessarily.

Myth # 1:  It’s easy to spot an alcoholic.

Contrary to popular belief, many alcoholics manage to keep their drinking under wraps and lead quite functional lives—until they don’t. You don’t have to be a drunk to be an alcoholic. Some alcoholics never appear intoxicated.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholism is characterized by the following criteria:

Craving –A strong need, or urge, to drink.

Loss of control –Not being able to stop drinking once drinking has begun.

Physical dependence –Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking.

Tolerance –The need to drink greater amounts of alcohol to get “high.”

Alcoholics often fool themselves into thinking they’re not alcoholic because they can “hold their liquor.” In fact, a high tolerance for alcohol is one characteristic of alcoholism.

I once treated a patient who came home from work every day, ate dinner with his family, and then drank a case of beer after everyone went to bed. He looked forward to his routine and didn’t see a problem with it because he wasn’t out at the bars and never missed work.

Was he an alcoholic? You bet. He craved his nighttime beer, had to finish his entire stash in one sitting, felt shaky and anxious if he couldn’t drink, and rarely appeared drunk.

Myth #2:  If you’re drinking to “self-medicate,” you’re not an alcoholic.

I’ve heard this rationalization countless times. Sorry. It doesn’t matter whether you’re drinking because you love the taste and feel of booze or just to steady your nerves. If you’re dependent on alcohol to get through the day or cope with another problem, you’re an alcoholic.

Here’s an interesting factoid:  About 20% of patients in treatment for Social Anxiety Disorder are also alcoholic.

Myth #3:  You don’t have a drinking problem if you don’t drink every day.

Alcoholism is only one type of alcohol-related disorder.  Problem drinkers may not be physically dependent on alcohol—that is, they don’t go through withdrawal when they stop drinking—but drinking may still interfere significantly with their lives. And, problem drinking can lead to alcoholism.

These questions from the NIAAA can help you determine if you have a drinking problem:

Have you ever felt you should cut down on your drinking?

Have people annoyed you by criticizing your drinking?

Have you ever felt bad or guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

One “yes” answer suggests a possible alcohol problem. More than one “yes” answer means it is highly likely that a problem exists.

It can be especially hard to recognize that you have an alcohol problem if heavy drinking is the norm among your colleagues or friends.  Many a college student has told me about prodigious excesses, while firmly denying a problem exists. Even though binge drinking is widespread on college campuses, its ubiquitous presence doesn’t necessarily inoculate students from becoming alcoholic.  It just makes alcoholism harder to detect unless, as with George Hugeley V, the alcoholic is prone to violent rages.  His friends, themselves hard drinking college athletes, were alarmed enough by Hugeley’s behavior to consider staging an intervention.  But they didn’t, and then it was too late.

Self-deception goes hand in hand with alcohol abuse.  If you find yourself invoking any of the three myths I’ve talked about to convince yourself or others you don’t have a drinking problem, you might want to reread the questions from the NIAAA. Most important, answer them honestly.