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Alcohol Use Disorder (AUD) is a medical diagnosis for a pattern of alcohol use that causes significant distress or impairment. It includes a spectrum of severity—ranging from mild to severe—and is based on how alcohol affects your life, not how much you drink on a given night.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), AUD is diagnosed when at least two of the following symptoms occur within a 12-month period:

• Drinking more or for longer than intended
• Unsuccessful efforts to cut down or stop drinking
• Spending a lot of time drinking or recovering
• Craving or strong urges to drink
• Alcohol use interfering with responsibilities at work, school, or home
• Continuing to drink despite relationship problems
• Giving up activities or hobbies because of drinking
• Using alcohol in dangerous situations (e.g., driving)
• Continuing to drink despite physical or mental health issues
• Developing a tolerance (needing more to feel the same effect)
• Experiencing withdrawal symptoms when not drinking

A qualified therapist for alcohol addiction or healthcare provider can help you assess your symptoms and guide you toward treatment options.

It’s common to wonder where the line is between social drinking and a potential problem—especially in a culture where alcohol is often normalized or even expected in social settings. Not everyone who drinks excessively has alcohol use disorder (AUD), but understanding the difference is key to deciding whether to seek alcohol counseling.

Signs of Social Drinking:

You may have a negative body image if you often experience:

• Alcohol is consumed occasionally and in moderation
• Drinking is not a regular coping mechanism for stress or emotion
• You can stop or moderate easily without cravings
• Drinking doesn’t interfere with responsibilities, relationships, or health
• There is no pattern of negative consequences (legal, financial, interpersonal)

Signs of Problematic Drinking:

• You often drink more than planned or struggle to stop
• You use alcohol to deal with anxiety, sadness, or stress
• You continue drinking despite relationship or health problems
• Loved ones express concern, and you become defensive or secretive
• You’ve tried to cut back but haven’t been successful
• You experience blackouts, hangovers, or memory loss regularly
• Your tolerance has increased—you need more to feel the same effects
• You find yourself thinking about drinking often or craving alcohol

If drinking feels like something you need rather than something you choose, or if you feel uncomfortable with your own habits, it may be time to speak with an alcohol abuse therapist or begin therapy for drinking problems.

You don’t need to wait for a crisis. Many people seek help before their drinking becomes severe. Catching a pattern early—especially with the help of a cognitive behavioral therapist for alcohol addiction—can prevent future harm and offer long-term benefits.

This is a nuanced question. For some people—especially those with mild AUD—moderation may be a goal, supported by therapy and structure. Others may find that abstinence is safer and more sustainable, particularly after repeated relapse or severe dependence.

Working with an alcohol addiction therapist can help you determine:

• Whether moderation is realistic for you
• What your motivations and risks are
• How to structure a plan with accountability and support
• Whether harm reduction or abstinence is the better long-term strategy

There’s no one-size-fits-all approach. Therapy empowers you to make informed, personalized decisions.

Long-term, heavy alcohol use can have profound and lasting effects on nearly every system of the body—and can also deeply impact mental and emotional health. The consequences often go unnoticed at first but become more serious over time.

Physical Health Effects:

• Liver Damage: Alcohol is processed in the liver. Over time, heavy drinking can cause:
  • Fatty liver (early stage)
  • Alcoholic hepatitis (inflammation of the liver)
  • Cirrhosis (irreversible scarring and liver failure)
• Cardiovascular Issues: High blood pressure, irregular heartbeat, and increased risk of stroke and heart disease
• Cancer Risk: Alcohol is classified as a Group 1 carcinogen—linked to cancers of the breast, liver, mouth, throat, colon, and esophagus
• Gastrointestinal Problems: Inflammation, ulcers, pancreatitis, and digestive issues
• Immune Suppression: Increased vulnerability to infections and slower recovery
• Neurological Damage: Including memory loss, numbness, or Wernicke-Korsakoff syndrome (a severe brain disorder linked to thiamine deficiency)

Mental Health Effects:

• Depression and Anxiety: While alcohol may temporarily numb stress or sadness, it ultimately worsens mood regulation and sleep quality
• Cognitive Decline: Long-term misuse can impair concentration, memory, and decision-making
• Suicidal Ideation: Alcohol lowers inhibitions and increases impulsivity, which can heighten the risk of suicide, especially when combined with depression
• Relationship Damage: Alcohol can fuel arguments, mistrust, codependency, or emotional abuse
• Emotional Numbing or Instability: Chronic use can dull your ability to feel joy, anger, or empathy, creating a sense of emotional disconnection

Even moderate drinkers may notice lower energy, poor sleep, and increased stress tolerance over time.

Working with an alcohol counseling therapist can help reverse or manage many of these effects—especially when treatment includes cognitive behavioral therapy for alcohol addiction, medical support, and lifestyle changes.