Visions Journal

Treatment for co-occurring mental and physical health disorders in young people

Seonwoo Hong, Taylyn Jameson, Yash Joshi and Joelle LeMoult

Reprinted from the The Vibes Are Off: Young People, Anxiety and Depression issue of Visions Journal, 2025, 21 (1), pp. 8-9

In our research and practice, we often see young people who experience more than one difficulty. For example, they might experience depression that co-occurs with other mental or physical health challenges. If you (or your child) experience co-occurring difficulties, you’re not alone. When this happens, it can alter the way symptoms present and how those symptoms are treated. 

The steps below can maximize the effectiveness of treatment and lead to better outcomes. 

Step 1: Understand the facts    

Anxiety and depression are becoming more common among youth. About 30% of teens will experience strong symptoms.¹ Often, anxiety and depression appear together. Some studies even show they might appear together more often than they do apart.² 

Anxiety and depression also commonly appear alongside other challenges, like difficulty paying attention. Anxiety and depression can even be associated with physical health challenges. For example, hormonal changes can impact how youth respond to stress. 

Mental health difficulties can look different depending on a youth’s cultural background. In some cultures, bodily symptoms, like headaches, stomachaches or feeling dizzy, can appear instead of feelings of sadness or worry. Cultural differences can make mental health concerns harder to notice and treat in the existing Canadian healthcare system. 

Given these factors, parents play an important role in their child’s mental health. Parents can support their child by being curious, asking questions and helping them notice changes in their behaviour. Working together can help youth get the right assessment and effective treatment to improve their mental health.

Step 2: Get a good assessment

You can’t treat what you don’t fully understand. A complete assessment is a key step in making therapy effective. A strong assessment considers all the important areas in a youth’s life, including their social world, school experience and behaviour, plus challenges like ADHD, learning difficulties or other mental health struggles. 

Even if these issues aren’t what brings a youth to therapy, they can still affect how that person feels. Sometimes what looks like anxiety or depression turns out to be a response to deeper challenges, like struggling to keep up at school due to untreated ADHD. Focusing only on anxiety or depression could mean missing an important part of the picture. 

It can be helpful for the therapist to gather input from multiple perspectives, including parents and teachers. These perspectives paint a fuller understanding of the challenges, shape realistic goals and a better treatment plan, and give therapy the best chance of making a difference. 

Begin by researching therapists. Don’t hesitate to ask questions. For example: 

• Do you specialize in working with kids, teens or families? 
• What training do you have in psychological and neuropsychological assessments? 
• What tools do you use? 
• How do you approach complex or overlapping concerns? 
• After the assessment, will we have time to talk about results and next steps? 

Some therapists specialize in both assessment and treatment. Others will recommend a treatment provider after the assessment.

If something doesn’t feel right, it’s important to speak up. Asking questions or voicing concerns is a sign that you’re engaged and advocating for yourself and your child. A good therapist will welcome feedback, stay open and work with you as a team to figure things out together. 

Step 3: Find the right treatment

When youth have multiple co-occurring conditions, a comprehensive treatment plan can maximize success. Here are some things to keep in mind:

Evidence-based treatment. A treatment provider should offer evidence-based treatment, meaning they use approaches backed by research. Cognitive-behavioural therapy (CBT) is one approach research shows is helpful for anxiety, depression and other mental health challenges. 

Sequential versus simultaneous.Talk to your treatment provider about the order of treatment. In a sequential approach, you target one challenge at a time (e.g., substance use before anxiety). In a simultaneous (or transdiagnostic) approach, treatment targets symptoms (e.g., difficulty regulating emotions) common to multiple disorders. 

Each approach can be effective. Deciding which to use depends on the clinician, what’s being treated and your child’s preferences and needs. If one condition is at the heart of several difficulties, that may take priority (e.g., ADHD interfering with school performance and friendships, which in turn contribute to depression and anxiety). Do not hesitate to ask your provider questions. 

Multidisciplinary team. Depending on the other challenges your child is facing, it can be helpful to consider a multidisciplinary team approach. That’s where multiple people work together. A team could include a psychiatrist, therapist, physician, teacher or school counsellor. Communication and note-sharing among experts can improve treatment success.

Support system. Treatment outcomes are best when youth have a strong support system from family, friends, community members or teachers. Talk to your child about what support they would find helpful from you. 

Lifestyle factors. Lifestyle factors like sleep, diet and exercise can help youths’ mental and physical health. They’re particularly relevant when multiple concerns are present. Fortunately, lifestyle changes can start today!

Reassessment. Sometimes, benefits in one area of mental health can improve, or amplify, concerns in another. Checking in with your child and their therapist throughout treatment helps manage changes in primary concerns. 

Although treatment progress is not always linear and often needs teamwork from many different fronts, youth are resilient. It’s wonderful that they’re seeking help early in life. The skills they learn in treatment can help them develop positive coping strategies they’ll use for years to come.