Steve Martorano 
The Behavioral Corner is produced in partnership with Retreat Behavioral Health -- where healing happens.

The Behavioral Corner 
Hi, and welcome. I'm Steve Martorano, and this is the Behavioral Corner. You're invited to hang with us as we discuss how we live today, the choices we make, what we do, and how they affect our health and well-being. So you're on the corner, the Behavioral Corner. Please hang around for a while. 

Steve Martorano 
Hi, everybody, welcome again. It's me, Steve Martorano, hanging, as I always do, here on the Behavioral Corner, where we talk about everything, because that's what winds up affecting our behavioral health. We hope you have found us if you have, let us know what you think. If you like it, that's great. If you don't tell us what's wrong. It's all made possible by our great underwriting partners Retreat Behavioral Health, they help us not only financially, but in a number of ways. Today will be another example of the help they bring us. We're going to talk about young adults, something we touched upon, frequently over the course of behavioral health. Sometimes it seems as though there has never been a more challenging time to be young. I'm sure every generation may feel like that. I certainly don't. I'm an old hippie. We had the greatest time in the world. All we did was run around and do whatever we damn well chose. But it's a challenge for young people today. And we're seeing some of the results of that challenge in what's being described as a mental health crisis among people of a certain age. You know, the list. It's everything from pandemics to climate change, worries to, "Oh, yeah, the college debt." So there's a lot on their plates, and some are having difficulties handling it. Those difficulties resulted in some problems, both in the mental health area and in the area of substance abuse, with us from retreat behavioral health, because we always rely on their expert people to join us and straighten things out Caitlin Austin. Caitlin is a primary therapist at Retreat Behavioral Health, and she deals with a lot of young people in these situations, we welcome her to the Behavioral Corner. Hi, Caitlin, how are you?

Caitlin Austin 
Hi, I'm doing good. Thank you for having me.

Steve Martorano 
Thanks for your time. We appreciate it. Am I wrong? Is it a very extraordinarily challenging time for young people?

Caitlin Austin 
Yeah, I would definitely have to agree with that, that right now. I've seen an uptick. And young people, young adults, definitely both men and women coming into the facility. I would say that, primarily, what I'm seeing is them with bipolar, schizophrenia, they are definitely having schizophrenia, mainly because a lot of them are smoking lead at younger ages. And that can be transferred into higher rates of schizophrenia, which we're finding out, which is actually quite interesting. There have been many studies done on that. And...

Steve Martorano 
Yeah, as a retired hippie. I never thought I'd reached the point in my life where I'd say that legalization of marijuana for recreational use is a bad idea. But it seems more and more to be the case that the I mean, decriminalization is one thing, you know, endorsing it and selling it and having it available everywhere. I think it's going to be a problem that already is, as you point out before we get into some of the nitty-gritty of how you handle those things with your patients. How long have you been in the field and tell me about your background?

Caitlin Austin 
So I've been in the field for about two years as a primary therapist. I've done everything from being a VHT to working in just different facilities doing other jobs, and I really enjoy it. I interned at other facilities. And right now I am working as a primary therapist, as you've already said, for behavioral health and it's really enjoyable. I really like working there.

Steve Martorano 
So let's talk about some of the things that you have you see a lot of...I mean bipolar sometimes it seems to me everyone is sooner or later going to be diagnosed as bipolar. What are some of the things that present themselves as bipolar? What should, for instance, people be looking out for?

Caitlin Austin 
When you are bipolar, I would say that high fluctuations of moods, like mood swings, either you are very happy or you're extremely erratic. needed at least, irritability, restlessness, and frustration. Also, maybe you're sleeping a lot. There are very, very challenging mood swings with that kind of disorder. So it's very hard to kind of diagnose sometimes because it comes up as many different things. That one can also be, misconstrued, I would say with borderline personality disorder, which is another one, which is very popular right now, especially in young adults, because that is very prone with families that are dysfunctional. So dysfunctional families, which is very common because alcoholism and addiction are also very common right now.

Steve Martorano 
Bipolar as opposed to personality disorder. It is one come before the other in terms of diagnosis.?

Caitlin Austin 
No, I...oh, you're saying bipolar like one or bipolar two? Is that when we're talking?

Steve Martorano 
Yeah. Yeah. Yeah.

Caitlin Austin 
So bipolar one is if you're manic, and then bipolar two is if you have hypomania.

Steve Martorano  
Well, you know, some of the things you've described, we are hyper hypo, I can understand but some of the things you described, it's not all of the things you describe, are stuff that we all face, the anxieties and the stresses, and all that and young people, it's exacerbated because they're young. Again, it becomes a problem when it's interfering with your life. Correct?

Caitlin Austin 
Correct.

Steve Martorano 
Young people have difficulty. Very young people anyway, have difficulty on impulse control, as a sort of normal thing among young people. What is the impact on impulse control when you're bipolar?

Caitlin Austin 
When you're bipolar? I would say it's it is very intense. Hence, the mood swings, I would say you just have a lack of self-regulation and ability for distress tolerance, no lack of emotional regulation, those kinds of things.

Steve Martorano 
Alright, so how do we let's talk about some of the things that you do to treat stuff like this...depression and anxiety we haven't even touched upon? I don't want to alarm you, by the way, to pause for a second, I don't want to alarm you at all. But there is something moving around in your bed, I think behind you or your couch or something.

Caitlin Austin 
Oh, my two dogs.

Steve Martorano 
I just wanted to make sure...

Caitlin Austin  
I know there...

Steve Martorano 
It was moving. And I went, "What in the world." Anyway, sorry about...

Caitlin Austin 
Are they very loud?

Steve Martorano 
No, no, no, no, you now in fact, in fact, just gotten comfortable. So they seem to be okay.

Caitlin Austin 
My boyfriend should be home any minute to like, move them.

Steve Martorano 
There was a moment there when I wondered whether or not that wasn't your boyfriend. But anyway, let's talk about some of the things that you treat how you treat some of these things. What do you do when somebody comes in and they're clinically depressed? They can't get out of bed. And now they've come to you for help? How do you get them moving again?

Caitlin Austin 
So I would say, at first, we would definitely recommend that they follow any detox protocols. So going to see the doctors and see if they're medication compliant. We put them on a strict medication regimen, and then see if that first works. However, we do combine that with daily process groups where you suggest that they go daily, and see a therapist, we also have a slew of therapists that they can meet with go over CBT or DBT skills. CBT stands for cognitive behavioral therapy, which is anything from worksheets to, you know, saying what they're thinking and either maladaptive thoughts can be switched to more adaptive thoughts. Then DBT would be just a dialectical behavioral therapy, which could be something like opposite action for somebody who is depressed. So something like that would be if you are depressed, you might not want to get out of bed and go to the group. So instead of laying in bed all day, you would get up and go to the group.

Steve Martorano 
Someone wants to ascribe the cognitive behavioral therapy to me...and you tell me if this makes sense to you very simply, he said, "If you change the way you think you will change the way you behave." Is that pretty much what CBT is all about?

Caitlin Austin 
Yeah, absolutely.

Steve Martorano 
Yeah. Do most or all of the young people you see self-medicate? Are they all on some...have substance abuse issues, as well as the CO-occurring mental health stuff?

Caitlin Austin 
Yeah, I would say that's pretty accurate. Read the majority, the vast majority of them.

Steve Martorano 
And what...and what are you seeing? Are you seeing opioid opioids or? Or the whole range?

Caitlin Austin 
I would say alcohol use disorder and opioid use disorder are primary and then along with marijuana also being...

Steve Martorano 
Are you seeing more...are you seeing more people with marijuana...they now describe marijuana use disorder as a disorder, right? How's that manifested? It'll be it's just people lying around listening to Grateful Dead records, or I can't imagine anybody getting high listening to Taylor Swift. But what are they doing when...

Caitlin Austin 
I mean, I don't think they're listening to Taylor Swift. No.

Steve Martorano 
Right. So one of the...you know, I when I...I think I understand what marijuana use disorder is intended to imply. But sometimes I have difficulty figuring out what that means. I mean, does everybody turn into you know, Cheech and Chong or whatever? Because you can you know what I mean, you can, unlike a lot of other drugs, more serious drugs, certainly alcohol, certainly opioids, you can sort of, you know, operate when you're high on marijuana. I mean, you know, it's, it's not as debilitating is. I don't think it's heroin. So what, what, what does marijuana disorder look like?

Caitlin Austin 
So marijuana use disorder cognitively impairs you as well as your judgment, your ability to take part in life, like you were saying earlier, like the inability to go to work. And also, your choices, so are surrounded about getting that substance, you know, getting more the desire to cut down on it, maybe they lack the ability to do so by themselves. So, you know, that might be part of the decision as to why they might seek treatment. And that's why I said, it's usually seen with another paired with another substance, like alcohol or opioid use disorder, not so much just by itself. But it, it could be part of another greater problem. If that makes sense?

Steve Martorano 
You know, as they legalize marijuana, both medicinally and now recreationally...particularly in the medicinal area, there was some early suggestion or hope that you could wean people off of things like alcohol or even opioids, substituted with marijuana. How do you feel about that idea?

Caitlin Austin 
Well, I think it depends on the person, I think that I do understand the idea of the lesser of two evils sometimes. So I'm, I'm very, I'm not very judgmental. When it comes to those things. I, if somebody has been doing heroin for like, 40 years, like, say, an older person, they are now just smoking marijuana, and that's the very best that they can do. You know, that is a win, for some people, you know? Sometimes we just have to take the win and allow them to live their life to the best of their ability. And if that's what they think that they need, then, you know, who am I to judge? Right?

Steve Martorano 
Yeah, well, yeah, and in the worst-case scenario, opioid use, and alcohol can, and very often does lead to death. Marijuana, in my experience, in the worst case, leads to stupidity. That's why they call it dope. So, uh, yeah, I guess it's an interesting trade-off. But I don't think anybody in your field corrects me if I'm wrong, is advocating for that it's kind of a go-to method, oh, we're gonna get you off this and you can start smoking grass.

Caitlin Austin 
It's definitely not like it's not the medical model, per se. So there are different models out there. And we definitely don't push for that. We definitely don't are like okay, like, we want you to go to a medical marijuana clinic. Now. I definitely working in Eritrea I would definitely not say that as well. But I'm saying that just as a therapist, sometimes what we need to do is work in collaboration with a client and where they're at mentally and their motivation for treatment. Sometimes in order to get them to be in a better space. We have to be in agreement with them and alignment on some of these decisions. And I think sometimes we have to look at those decisions and you know, the lesser of two evils is sometimes the better decision versus you know, them going back to the worst of the two evils. So...

Steve Martorano 
Caitlin Austin is our guest a primary therapist with Retreat Behavioral Health. And we're talking about the client base or patient base she's most familiar with. And that's young adults, we're talking about what are we talking about 18 to 24...25 is at the age rating, we're talking about?

Caitlin Austin 
Yeah, I would say 18 to 24...25.

Steve Martorano 
I know a part of the treatment that I've read about involves, you know, basic life skills. What are some of the things that young people need to get better at in terms of life skills?

Caitlin Austin 
So for example, I had a group today, and a client was saying how one of the things that they really struggled with was just making doctor's appointments, like their parents had enabled them to the point where they didn't know how to do simple tasks like that, because they have always had like a helicopter parent, taking care of them, doing a, b, and c for them. So when it came time to just, you know, do simple things, they didn't have the wherewithal or understanding on how to do that. So I mean, just something simple, like calling the doctor like, what do I say to the doctor? How do I handle these conversations? So like, effective communication skills are things that even 18 like you were saying, 25-year-olds don't really know now, and I don't know of all the technology now, does that play a role? I'm not quite sure.

Steve Martorano 
Do you mean hindering their basic life skill...life skills? Or?

Caitlin Austin 
I'm not sure how much that plays a part as well.

Steve Martorano 
Well, you don't have to spell...you don't have to know how to spell. And no one uses punctuation anymore. You shouldn't be stumped for any question. I mean, somebody asked your question, or you just Google it. So I mean, you can't get into a habit of using that phone to do its thinking for you, which is not a good thing when you're making mistakes. Right?

Caitlin Austin 
Yeah. And I think also too, even just having to not always see people face to face, especially since we were talking about earlier COVID. I think for people who have social anxiety, naturally, that really put a hindrance into their ability to communicate effectively as well, because then they didn't need to kind of show up for themselves in the way that they might have needed to. And the substances just also kind of allowed them to get away with, you know, whatever they needed to.

Steve Martorano 
It's one of the great ironies of social media is that while it can gather people together, it has been shown to isolate too a great number of people. And that, of course, was writ large during the pandemic. So, Caitlin, you're in the field now? Seven, eight years, 10 years, whatever you said. You're also in recovery.

Caitlin Austin 
Yes.

Steve Martorano 
Five years sober?

Caitlin Austin 
Yes.

Steve Martorano 
Excellent. Can you share your story with us a little bit? When did your substance abuse start? And what shaped Jake and how did you finally get sober? Yes,

Caitlin Austin 
I would say that being adopted definitely played a role in my story. I definitely felt like abandoned the neglect, I can identify with that. So when I was 12 years old, I started using weed and alcohol. And I feel like I can identify with people who maybe misbehaved in high school. I started acting out then I would drink before school, and I almost got kicked out for fighting. It's funny thinking back now I can never see myself acting that way. But I was just fighting with everyone. You know, I kind of wanted to take out the anger that I felt towards my family life...like I had such a dysfunctional family life and a lot of stuff going on. My dad was one of eight and he had a lot of alcoholism in his family which was hidden.

Steve Martorano 
Your adopted...your adopted father or your biological father?

Caitlin Austin 
My adoptive father.

Steve Martorano 
Okay.

Caitlin Austin 
So my dad was one of eight he had a lot of alcoholism going on in his family. My dad was beaten as a child. And what I realized by going through recovery is that your parents can only love you with like, what they know how to, right? So basically forgiveness and understanding and compassion. And at the time when I was younger, when I was in school, I wanted everyone to feel how I felt. So I was very angry. I wanted everyone to feel that anger. So that's why I was fighting and I almost got expelled.

Steve Martorano 
You're fighting other girls or...

Caitlin Austin 
Yeah, other girls. Yeah, like the older girls, I felt like were picking on me. So I felt like I had to stand up for myself. But like, looking back it like takes two to five takes two to tango. Right? So...

Steve Martorano 
How well did you hold up against the older girls? I'm just curious. Did you hold your own against them?

Caitlin Austin 
I thought I did good with one the other one, no. But then like, there's also like, online too. I feel like this is when the online stuff started when like, the Facebook stuff and the bullying over online. So I really relate with anyone who felt bullied and all that stuff. So I can identify with that.

Steve Martorano 
How bad is substance abuse get?

Caitlin Austin 
Pretty bad...pretty quickly, I would say. And I the isolation as well.

Steve Martorano 
It progressed to a...how far did it go. I mean, it was basically alcohol and marijuana or, with or harder stuff?

Caitlin Austin 
I started doing cocaine. And then when I moved to Florida, I started doing molly, which was like big down here, which is like other stuff. It has like someone said it has like meth in it or something. And then eventually, what is interesting is the guy I started dating, when I moved down to Florida, the day I got down to Florida for college, he was fresh out of detox and brought me to my first AA meeting. And I didn't even know you could live life sober. Like I didn't know what that was. And then, like, that's kind of how the seed was planted for me to....

Steve Martorano 
Yeah, prior to that first meeting, going into that first meeting with him. You are not thinking I gotta do something about this, right?

Caitlin Austin 
No, I didn't know anything...like I didn't know there was an issue.

Steve Martorano 
This is interesting. Tell me about that. So what we so you're sitting in this meeting, and you see all these people who are just telling you, you know how bad it was for them and how good they're doing now. Did you...did you...did you relate to it? Or how did it affect you?

Caitlin Austin 
Yeah, no, it was weird. Because I had never like, come from like my house, like both my parents are retired Navy officers. So they don't share their feelings. Like everyone was sharing their feelings and being very, like, open and warm and loving. And I was like, Okay, this is like completely different from like, what I like grew up with. And then like, I was 18. I just got into college, so I wasn't ready. So that's why I said the seed is planted.

Steve Martorano 
Okay. Yeah, did you...so did you get your treatment? Did you get formal treatment for substance abuse?

Caitlin Austin 
No, I never went to treatment. But the very last time I had used it, I had thought I needed treatment. And I, I always recommend treatment for people because there are people like we were talking about earlier who have severe mental health problems. And you know, I've had times where I've needed to definitely see people like psychiatrists for my health. And also people who are dealing with major substances like maybe for me, like I might have a need to see someone for molly like coming off meth. Heroin, for example, you don't really want to come off that cold turkey, you might need to be evaluated by somebody. You could go into seizures, anything. So these are really serious issues that could occur if you don't go and see a medical professional.

Steve Martorano 
No, you're absolutely...you're absolutely right. And I know you don't want to suggest to people that you're looking at me, I just quit.

Caitlin Austin 
Yeah, yeah.

Steve Martorano 
But the truth is, some people just do that. Some people do mature out of the behavior and never abuse the substance again. But you're absolutely right. Just because you're stopping that behavior. That doesn't mean you've dealt with all that stuff underneath.

Caitlin Austin 
Yeah.

Steve Martorano 
That caused the behavior to begin with. Right?

Caitlin Austin 
Yeah, absolutely.

Steve Martorano 
Yeah, so...so yeah, we don't we don't mean to suggest but you know, you're at least you're absolutely honest about that. So did this whole experience. what point did you go, Okay, I've got that together. You were gonna go to college? I don't know how well you would have done if you were still doing molly, but you kept it. And when did you decide this is something you could do professionally?

Caitlin Austin 
So after the pan...like during the pandemic, I would say before the pandemic I was working for somebody. I don't know if I should say his name wouldn't want me to, but he's in the room. And he helped me out. He got me a job at a restaurant down here in Boca and then the pandemic hits. So I thought like, what should I do with my life? Like, how can I, like continue working with people on helping people? And then I thought, like, maybe I should go back to school and become a therapist. So that's what I did. And that's how I've been on this track ever since it wasn't like, I wanted to become this. Like, it just kind of happened.

Steve Martorano 
Funny how things just kind of happened, right?

Caitlin Austin 
Yeah.

Steve Martorano 
Yeah. So let's, let's say we can wrap this thing up. Caitlin, I've been doing this for a very long time on the show. And I often worry that, no matter what we're talking about, with regard to mental health, and substance abuse, I worry that it's too often directed to older people who might not have the problem but know young people who do. Because I wonder whether young people would gravitate toward a show that said, hey, get sober. So, so if there are young people out there or older people now, how do they make that move? How do you say to somebody Young, who thinks they're invincible? Who's making wrong judgments? And abusing self? How do you can you push them? Can you send them in the right direction?

Caitlin Austin 
I mean, I would say, honestly, I'm not sure. Like, I feel like I had to hit my bottom with substances. I think that that takes a lot of understanding and listening. I think that that would be the best suggestion is just to be there as a person to listen and hear them out. Because maybe they haven't had that somebody.

Steve Martorano 
Yeah, well, we live in an age of fentanyl. So there's not a lot of margin of error. So it's probably worth reminding people that, even while they're making bad decisions, you don't get that many chances. Oh, by the way, did you ever...have you ever tried to reach out to your biological parents?

Caitlin Austin 
Yes. Yeah. Well, I went on the 23andme thing.

Steve Martorano 
Oh, did you meet them?

Caitlin Austin 
No, no, I found, like, my uncle or something. It wasn't...

Steve Martorano 
A family member.

Caitlin Austin 
Yeah.

Steve Martorano 
I wonder whether that's, you know, sometimes whether that's like, you know, the source of your anger was this alienation you felt? I'd be you know, adopted and not fitting. wondered whether that...Did it help me to know that you had real family out there?

Caitlin Austin  
Yeah. And I think also finding out that like, there was alcoholism in the bloodline of the family gave me some understanding and just kind of solidified the fact that like, you know, okay, like, this is a fact, you know, and I have a predisposition to alcoholism. And once I pick up one drink, then like, all bets are off. And sometimes people need that.

Steve Martorano 
Yep, absolutely. Absolutely. It will, you know, you weren't unlucky. You were unlucky, in a sense, but at least there's some sort of biological foundation for it. Caitlin Austin, thanks so much for joining us. We appreciate your time.

Caitlin Austin 
Thank you.

Steve Martorano 
And I'm glad we didn't disturb the dogs. I think he's still asleep there. I hope he's not on your pillow. Take care. Thank you all for that pay attention to us. When you do. Don't forget to hit the subscription button. We appreciate that. And we'll catch you next time on the Behavioral Corner.

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