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A key MAC assessment competency is differentiating primary psychiatric disorders from substance-induced presentations by examining temporal relationships. Depressive symptoms that emerge during heavy alcohol consumption and improve with sustained abstinence fit substance/medication-induced depressive disorder. Alcohol’s central nervous system depressant effects, sleep disruption, and neurochemical changes can produce dysphoria, anergia, and hypersomnia; early recovery may also produce transient mood symptoms that gradually remit. Primary major depressive disorder (A) is more likely if symptoms predate use, persist well beyond cessation, or recur in the absence of alcohol. Cyclothymic disorder (C) involves chronic hypomanic and depressive fluctuations over years, not an acute, use-linked course. Persistent depressive disorder (D) requires at least two years of depressed mood. Best practice includes monitoring mood over several weeks of sobriety, screening for suicidality, addressing sleep, activity scheduling, and coping skills, and coordinating with medical/psychiatric providers before initiating antidepressants, especially when diagnostic clarity is pending. Measurement-based tracking (e.g., PHQ-9) supports accurate diagnosis and stepwise care.