Many people in treatment notice a frustrating pattern: as one problem eases, another comes into view. That’s common. Anxiety and depression often appear together. Trauma and substance use can feed each other. Obsessive-compulsive disorder sometimes occurs alongside an eating disorder, and each can make the other harder to treat. Clinicians call this comorbidity, meaning two or more conditions present at once. When comorbidity is present, treating only one condition in isolation often isn’t enough.
We spoke with Abby Poplis, a licensed clinical social worker and the Executive Director of Compass Health Center’s Oakbrook location, about why mental health conditions so often occur together and how Compass treats them at the same time rather than one after another.
Please note: This interview has been condensed and edited for clarity.
What does “comorbid” mean in mental health treatment?
Abby Poplis, LCSW: In simple terms, comorbid means having two or more conditions at the same time. Most often at Compass, we see two or more mental health conditions. It’s important to note that this isn’t “worse” than having a single diagnosis; it’s just more complex.
Some of the most common comorbid combinations we see include:
- Eating disorders paired with OCD or anxiety
- ADHD alongside mood or anxiety disorders
- Substance use and trauma
What causes comorbid mental health conditions to develop?
Abby Poplis, LCSW: A combination of biological, psychological, and social factors. In our field, we use the biopsychosocial model, a holistic framework that looks at how physiology, psychology, and social environments interact to shape mental health.
For example, someone with a family history of substance use and a predisposition to depression is also dealing with poor sleep and conflict at home. That conflict can trigger depressive symptoms, which worsen sleep, which deepens the depression further. That person may turn to substances to cope, more likely so if they grew up watching that pattern modeled at home. Over time, substance use can reinforce negative beliefs (“I can’t handle this,” “I’m just like my parent”) that feed right back into the original symptoms.
It becomes a cycle, and understanding that cycle is the first step toward breaking it.
Why is it important to treat comorbid mental health conditions together, rather than separately?
Abby Poplis, LCSW: Treating comorbid conditions means looking at the whole person, not just the symptoms of a single diagnosis.
Consider someone with both PTSD and a substance use disorder. If treatment focuses only on the substance use, that person leaves still carrying the full weight of their PTSD symptoms and they’re significantly more likely to relapse, because we’ve removed their coping mechanism (alcohol, for example) without giving them new tools to manage the trauma symptoms underneath it.
The same is true in reverse. If we treat the individual’s symptoms but ignore the environment feeding them—say, ongoing family conflict—that conflict continues to trigger the same cycle after discharge. Addressing the whole picture, including family dynamics, is what creates durable, long-term results instead of short-term symptom relief.
How does Compass Health Center treat comorbid mental health conditions differently than other providers?
At Compass, we use a multidisciplinary treatment model built around coordinated care, not siloed care. A single patient’s team includes:
- A psychiatrist or psychiatric nurse practitioner
- A primary therapist
- A family therapist (required for patients under 18; available for adult patients as well)
- Group therapists who work with patients daily
- Additional specialists depending on age and program. For example, an education specialist for adolescents or a resource therapist for adults
The value isn’t just having these roles filled; it’s the coordination between them. Every day starts with treatment team rounds, where the full team collaborates on each patient’s care. That collaboration continues throughout the day and extends to outpatient providers as well.
Because a patient may present differently in a one-on-one session than they do in a group setting, having multiple perspectives in the room, literally and figuratively, means the team can catch things a single provider might miss. This coordinated approach starts at intake, with a comprehensive assessment designed to surface comorbid conditions early so they can be treated in the right order, together.
What evidence shows that treating the whole person leads to better outcomes?
Abby Poplis, LCSW: We see it in both our outcome data and in patient stories.
On the data side, Compass tracks outcome measures—for example, using standardized anxiety or depression scales to measure symptom change from admission to discharge—and compares recidivism rates (how often patients return to a higher level of care) against industry benchmarks. Our data shows lower recidivism and greater symptom reduction when comorbid conditions are treated together.
Anecdotally, this plays out constantly. One patient came to Compass with depression and, unknown to the team at the time, an undisclosed eating disorder. During that first stay, she wasn’t ready to disclose the eating disorder or participate in family work. Her depression improved and her functioning stabilized enough to discharge, but soon after, her eating disorder symptoms escalated, along with her depression and now anxiety too, and she returned to program.
The second time, she was ready. She disclosed the eating disorder, agreed to work with an outpatient dietitian, and participated in family therapy, which turned out to be a turning point for her and her family. That stay led to lasting results. We haven’t seen her back in program since, and the updates we’ve received have been consistently positive.
How are treatment plans individualized for comorbid mental health conditions at Compass Health Center?
Abby Poplis, LCSW: Every patient’s treatment plan is built around personalized, meaningful goals developed collaboratively with the treatment team (and family, where appropriate).
With comorbid conditions specifically, sequencing matters. For example, if a patient has depression with suicidal ideation or self-harm urges alongside OCD, safety and stabilization always come first before any exposure-based work for the OCD. Jumping straight into exposure work could intensify symptoms and put the patient at greater risk. Regardless of the specific diagnoses involved, stabilizing safety always comes before work that could be triggering or symptom-intensifying.
What happens when only one mental health condition or symptom gets treated?
Abby Poplis, LCSW: One of the risks of treating a single symptom instead of the underlying condition is what we call symptom whack-a-mole. One symptom improves, but because the root cause was never addressed, another pops up in its place.
For example, in OCD treatment, addressing a single compulsion (say, checking the oven repeatedly) without also building the patient’s tolerance for the underlying intrusive thoughts often means a new compulsion takes its place—checking locks, for instance. We see the same pattern with mood conditions: treat the anger on the surface without addressing what’s underneath it, and it may resurface as sadness instead.
This is exactly why treating the whole person, not just the presenting symptom, matters.
What should a parent or patient do if they suspect there’s more going on than a single mental health diagnosis?
Abby Poplis, LCSW: First, trust that instinct. Parents, in particular, tend to know their child best. If something feels off, it’s worth pursuing further, and worth finding a provider who listens closely.
From there, a few things help clinicians see the full picture:
- Share the full history instead of just current symptoms. Understanding a patient’s baseline—how they used to function versus how they’re functioning now—helps clinicians identify what’s changed and why.
- Note patterns across settings. A behavior or symptom showing up at home, at school, and in social settings is more significant than one isolated instance.
- Don’t overlook physical symptoms. Mental health conditions frequently show up physically. Think stomachaches, headaches, or other recurring physical complaints. These are often clues, not separate issues.
- Consider family history, even undiagnosed patterns. A grandparent who struggled but was never formally diagnosed can still be a meaningful clue in understanding a patient’s presentation.
When clinicians conduct a thorough evaluation, comorbid conditions tend to surface naturally; or at minimum, put the team on alert to look further.
Why is it hard for patients to disclose everything going on with them, and what helps?
Abby Poplis, LCSW: Disclosure is hard, especially when guilt, shame, or trauma are involved, and that’s completely normal. Patients don’t have to share every detail right away to get effective care.
If a patient isn’t ready to talk about a specific traumatic event, for example, it still helps enormously to be open about that, “I’m not ready to talk about what happened, but here’s how it’s affecting me.” That alone gives clinicians enough information to see the bigger picture, even without every detail filled in.
It can also help to ask someone close to you—a partner, friend, or family member—what changes they’ve noticed. Often the people around us can spot patterns we’ve normalized in ourselves, like sleep changes we’ve stopped registering as unusual.
This is also where Compass’s team-based model adds value. A patient might seem comfortable and open in individual therapy, but a group therapist may notice they’re pacing, isolating, or avoiding participation, information that adds an entirely different layer to the clinical picture.
Is there hope for people struggling with comorbid mental health conditions?
Abby Poplis, LCSW: Yes, and I say that genuinely. Mental health challenges, especially layered ones, can feel overwhelming, but treatment works. Our data and our patients’ outcomes consistently point to real, lasting improvement when the whole person is treated, not just isolated symptoms. If you suspect there’s more going on than a single diagnosis explains, that’s not a reason to wait. It’s a reason to seek care built to treat the whole picture.
