The Importance of Differential Diagnosis in the Treatment of Alcohol Use Disorder: Why It’s Essential for Lasting Recovery

Getting a differential diagnosis in the treatment of alcohol use disorder means carefully screening patients for any possible mental illnesses. The symptoms and signs of substance abuse can be similar to depression, anxiety, and other mental health conditions. Alcohol may trigger mental health symptoms, or the symptoms may occur first and lead to self-medication with alcohol. The interplay between both is complicated. It is essential to effective treatment and recovery to sort through them and make accurate diagnoses for patients.

To treat an illness requires that you know what it is. A doctor, therapist, or mental health team cannot build the best treatment plan and provide the most effective therapy without an accurate understanding of a patient’s symptoms and their underlying causes. Alcoholism and co-occurring disorders are common. The first step toward successful and long-term recovery for any patient is to be screened for all substance use disorders and mental illnesses by an experienced mental health professional.

The term differential diagnosis refers to the diagnosis of one or more conditions that have similar or overlapping symptoms. Mental illnesses and substance use disorders cannot be diagnosed with a single test, like some medical conditions can. These behavioral conditions are too complicated, and to diagnose them requires taking into account medical history, responses to questionnaires, symptoms, and observation of behaviors.

Mental health professionals must be able to differentiate between the symptoms of multiple conditions to make the most accurate diagnosis. For instance, someone struggling with alcohol may also have low moods, loss of interest in activities, restlessness, and social avoidance. The symptoms may be caused by drinking, but they could also indicate the patient has clinical depression or an anxiety disorder.

Alcoholism and Co-Occurring Disorders


It is common for individuals with an alcohol use disorder to also have one or more mental illnesses. And the opposite is true as well: someone with a mental illness is more likely to also struggle with alcohol or drug use. This relationship is well-known and well-documented, but it is complicated. There are three main reasons that co-occurrence is common:

  • Alcohol misuse can trigger symptoms of mental illnesses, like sadness and depression. The complications caused by alcohol use disorder, like financial problems or domestic abuse, can also lead to mental health symptoms.
  • Mental illness symptoms can lead a person to drink in order to try to feel better. This is known as self-medication and often leads to a substance use disorder.
  • Alcohol use disorder and many mental illnesses have similar risk factors, including the experience of trauma and frequent life stressors.

Some of the mental illnesses that more commonly occur with alcoholism include bipolar disorder, depression, anxiety disorders, dysthymia, post-traumatic stress disorder, and some personality disorders.

Why Differential Diagnosis in the Treatment of Alcohol Use Disorders Is Essential


A diagnosis is the first step in the treatment of any kind of illness. It is the biggest factor in guiding treatment. Without a firm and accurate understanding of existing conditions, treatment can go in the wrong direction and prove ineffective or only partially effective.

A patient seeking treatment for alcohol use disorder may genuinely have a mental illness as well. But some people may only have symptoms caused by alcohol use. When the drinking is addressed and stops, the symptoms go away. It is especially important to make a differential diagnosis so that patients with independent, co-occurring mental illnesses can be treated appropriately.

If an existing, independent mental illness, like depression, is not diagnosed and addressed, the treatment for alcohol use disorder will only be partially effective. It may lead to recovery, but it will likely be short-term. Recurrences of a depressed mood are likely to trigger a relapse, requiring additional treatment.

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Benefits of Integrated Treatment for Alcohol Use Disorder and Co-Occurring Conditions


With a differential diagnosis, patients get better treatment and results. There is a lot of evidence from research that integrating care gives patients better outcomes. Integrated treatment means that all conditions—alcohol use disorder and any diagnosed mental illnesses—are treated at the same time, by the same team of caregivers, and within the same program and setting.

Studies have shown that patients with co-occurring substance use disorders and mental illnesses who received integrated care were more likely to abstain from alcohol or drugs six months later. Even five years later, patients who got integrated treatment were less likely to relapse than those who received separate treatments.

The evidence also supports long-term integrated treatment. Patients who received integrated care for two months or longer were more successful in recovery and had fewer relapses than those in treatment for less than two months. Lasting recovery depends on getting treatment for all mental illnesses and substance use disorder at the same time. And this cannot be achieved without a differential diagnosis.

What Integrated Treatment for Alcohol Use Disorder Looks Like


The best outcomes for patients with co-occurring conditions result from long-term, integrated care. And the best way to get this is in a residential facility that specializes in differential diagnosis and integrated treatment. If you or someone you care about is struggling with alcohol, make sure you seek treatment at a facility that can provide this expert care.

One of the major benefits of such a treatment center is that the treatment plan looks different for each patient. The professional staff develops an individual course of treatment for each patient that matches their needs, limitations, preferences, and abilities.

For treating alcohol use disorder and mental illnesses, the focus of care will be therapy. Behavioral therapies are effective in helping patients understand their motives and behaviors and make lasting, positive changes. Good therapists help their patients understand the complex relationship between drinking and their mental health symptoms. They guide patients to find better ways to cope with and manage those symptoms so they don’t have to turn to drinking again.

Treatment also typically includes group therapy and support, family therapy sessions, medical care, medications if appropriate, and alternative therapies like acupuncture, music therapy, or recreational therapy. This range of treatments, along with healthy lifestyle changes, diet, exercise, and social support, can only be provided by a residential facility.

Differential diagnosis is so important to long-term recovery for alcohol use disorder patients. If you or a loved one is struggling with alcohol, insist on an accurate diagnosis, and get a second opinion if you are not satisfied. This is the only way to get effective, integrated care.

Need Treatment for Alcohol Use Disorder?

Constellation Behavioral Health is proud to be a leader and innovator of addiction recovery and mental health services. Our integrated, shared system of care ensures quality of care across all of our facilities, with a distinct focus on providing a robust differential diagnosis, cultivating personal agency, and working closely with families and healthcare providers to ensure the best chance for lasting recovery. Coordination and collaboration of staff across our different facilities contribute to consistency of quality and shared treatment philosophies.

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Alta Mira is a residential treatment center providing world-class care for individuals suffering from addiction and complex co-occurring psychiatric and medical issues. Our renowned staff of medical, psychiatric and addiction specialists offer the most sophisticated level of clinical and diagnostic services. We promise an extraordinary and transformative treatment experience for clients and families providing intensive workshops, and a broad selection of integrative and experiential therapies to promote recovery and deep healing.

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