Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host Helen Dandurand. Today I'm going to be joined by Caitlin Garstkiewicz, Riverside Behavioral Health School Liaison to talk about stress management.

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Host: And we are back with Caitlin. Thanks for joining me today.

Caitlin Garstkiewicz, LCSW: Yes, hi Helen. Thank you guys for having me.

Host: No problem. So could you start by just telling us a little bit about yourself, your background?

Caitlin Garstkiewicz, LCSW: Yeah. Yeah. So I am a licensed clinical social worker. So I have my Master's in social work and I started in mental health around 2013 in my undergrad, at my first internship. And, mental health has kind of just captured me. Always kind of knew I wanted to work in the helping field. So I have been here for a minute at Riverside. I work as a behavioral health school liaison, and I just joined in December. So I'm very happy to be here. And it's been great.

Host: Awesome.

Caitlin Garstkiewicz, LCSW: As a hospital school liaison.

Host: Well, great. So it sounds like you're very qualified to talk to us about this topic.

Caitlin Garstkiewicz, LCSW: Yeah.

Host: So the basics, let's get this out of the way. What is stress and how does it affect us mentally and physically?

Caitlin Garstkiewicz, LCSW: Right. So, kind of just to like a very definitiony definition of stress, it is a natural response that our body has to either internal or external stressors, that can affect just like you had said, mentally, physically, cognitively, even, emotionally. So we oftentimes think like, oh man, I'm so tired, like physical, or I might think, oh, I'm so overwhelmed. And that might be an emotion, but stress actually, I feel like is something that seems so simple in a way to talk about.

But it actually is much more involved than I think that we even talk about. So, some of the physical impacts, obviously, sleep can be impacted. Our body can become stiff, sore, as its natural response to stressors we might tense up. Also, our physical health, like our blood sugar can increase over prolonged periods of stress.

So physically we really can be impacted. And then emotionally, of course, we can start to really feel potentially depressed or have experiences of deep, like hopelessness or helplessness, sadness, anxiety, even anger can be a way that some of us can respond to stress. But then, we talk about mentally and cognitively and those are kind of related to emotionally, but cognitively really is we can start having brain fog after prolonged periods of stress, have difficulty finding words, have difficulty with our normal routines. So it really is like a full body experience. And it's important to pay attention to.

Host: Yeah, definitely. I mean, I think a lot of those things kind of just sound like what folks would attribute to, oh yeah, I'm just getting older. I guess this is what it is to be an adult and it's good to kind of take stock in those things and to make sure you're taking care of yourself, right.

Caitlin Garstkiewicz, LCSW: Yeah, absolutely.

Host: So I've heard before, I remember this in like high school health class. There's good stressors and there's bad stressors. Can you explain kind of the difference and how to recognize those in our lives?

Caitlin Garstkiewicz, LCSW: Yeah, yeah. So it kind of seems right, like how could stress be good? But there's definitely stress, in even our good things. So good stress would be those things, the stress related to things that ultimately are positive that we want, that we enjoy. So like planning a vacation, planning a wedding. Right. Those are bigger examples of that good stress or even too for, those that are parents, running around to games and activities, that's technically, in a way, an element or a type of good stress. Because we love our kids if we have them. And all of that. But, it still weighs on our body and our mind.

And then bad stress would be that stress that comes from something that isn't going well or isn't going right in our lives that we really wouldn't feel or receive any positive from, right? So, we are short staffed at work or a partner or two partners are having difficulty with their relationship or financial issue. So, that's the big difference between good and bad and the way to decipher the difference is hey, like ultimately is there something positive here for me?

Host: Yeah.

Caitlin Garstkiewicz, LCSW: That would be really one of the, the biggest differences.

Host: Yeah. So, you listed some of the good types and the bad types, a few there. But, what would you say are some of the most common, they might overlap a little bit, stresses that you see?

Caitlin Garstkiewicz, LCSW: Yeah. I feel like there's definitely a top three or five that we will consistently hear about, in the world of mental health, and that would be finances, managing daily life, and all of our priorities, and then relationships or family stress. Those have definitely been the most common sources of stressors. We're all designed differently. We have all developed differently. So I think something that's really important to name is that, for one person, finances, even if there's some sort of trouble or even a major trouble, someone might respond, not as, and I have air quotes here big yes, as other people might. And that could be because of maybe we experienced financial trouble in our childhood and at this point we're just burnt out by financial stress.

 So those definitely are the most common types of stressors. But, we see some fluctuation in the capacity that people have for different types of stressors too.

Host: Yeah, definitely. So how can chronic stress end up impacting our long-term health if it's left unmanaged?

Caitlin Garstkiewicz, LCSW: Yeah. So earlier when we had talked about, like what is stress and the different areas of stress, we see those long-term impacts, from stress in physical or mental, cognitive and emotional as well. I think that when we talk about chronic long-term stress; physical implications and impacts are kind of the number one. Prolonged periods of stress or even, trauma that we've experienced that goes unresolved or we don't take care of it maybe as we should or would be best for us; we can see things like individuals that experience long periods of stress do tend to have higher rates of potentially diabetes or heart disease, comorbid physical health needs, right? So having more than one, physical health diagnosis, especially if we have that predisposition in our family.

And also I feel like too, when it comes to long-term stress from being tense or not taking care of ourselves, like eating regularly, drinking water like we should, even getting like little movement that isn't connected to a demand, it can keep us kind of tense and I don't want to say like irreversible, you know, tenseness.

But it can definitely when we start to realize and say, Hey, like I need to do something about this; it can take us a little bit longer, or take more intentionality or more practice or even more types of approaches to manage that stress, or how that physical stress has shown up for us.

But emotional too. We get tired. I use a lot of analogies in my work and one of the analogies that I often use is a car and a car with gas and a car that needs tuneups and, potentially things replaced. Right? Like brakes or different things like that. And, we very much are the same way.

Host: So it's a great analogy.

Caitlin Garstkiewicz, LCSW: Yeah. Yeah.

Host: If someone's listening to this and they're like, wow, that really is me. I'm, I've been running on E or, you know, whatever and they want some kind of quick, practical techniques to help them when they're feeling overwhelmed and feeling stressed. Or even, I mean, I know that you kind of work with children so it can help someone else when they're feeling stressed their child, their family.

Caitlin Garstkiewicz, LCSW: Absolutely. So I think two things come to mind when I hear this. Number one, and it sounds maybe a little overrated or over spoken about, but taking a pause. But the big thing there is, is taking an intentional pause. So if we literally just pause and say, man, I'm stressed. And then continue on with whatever we're doing, yeah, we're not going to see too much of break. Right, right. So taking a pause where maybe we set a timer, and it doesn't have to be super long.

It can be two minutes, five minutes, 10 minutes would be awesome. But even two minutes by taking a pause and just disconnecting from the stressor or from that current moment, just for a minute, and maybe really being in your environment and noticing like, oh, I, love the way my office looks. Or, oh, I should really freshen this up.

Maybe that could help my environment, or, daydream a little bit. But I also say, our mind and our body is so deeply connected, that deep breaths. So just inhaling, at least for five seconds, exhaling for the same amount. Um, but doing it consistently and over and over again is really helpful.

So taking that pause. I will say, and I'm even one of those too, like with my own mental health needs that, sometimes I would get a little frustrated when people say like, just take a pause or just take a breath, or things like that. And it's not, are we going to have an automatic, we're back to a hundred percent? I, no. Like, I'm going to tell you no, we're not. Right. But research has shown us consistently that deep breath, mindfulness, even in short periods of time are going to help us detach from that stress for just a moment to try to get our body a little bit more regulated. And then when it comes to kids, in my work with kids, validation. Kids just want their parents to tell them I get you. And even if maybe they don't quite get it, letting them know that, Hey, I'm here and I'm listening and this sounds so big for you. This is so stressful. That is truly, I would have to say is the number one thing that it always comes back to is just they want to know that they're seen and not alone in their experience of stress.

Host: Yeah, definitely. We're going to take a quick break to talk about primary care at Riverside. Consistency is being able to count on someone to be there when you need them. At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive. Find the right primary care provider for you at myrhc.net/acceptingnew. From annual screenings to well checks and everything in between, having a primary care provider that you can trust makes all the difference.

And we are back. Can you talk a little bit about the connection between sleep and stress and how to break maybe like a poor cycle of sleep that can be caused by that?

Caitlin Garstkiewicz, LCSW: Mm-hmm. Yeah, so sleep and stress, they go hand in hand and unfortunately it's that two-way relationship in that the higher our stress, the more likely our sleep is going to be impacted and vice versa. The, if our sleep is impacted, the more likely we're going to be stressed. So it can be very tricky and quite honestly, I would say can be really a big challenge for people.

We can really feel helpless when we have difficulty sleeping. And it kind of becomes like a, an element of desperation in there right? For rest. So, I think a really important or helpful way to try to improve our sleep, especially when we're stressed, is making sure that we have a transition time, between when our day comes to an end at work or comes to an end in regards for those that have children. So, okay, all the activities are done. We're in for the night. Try to have some sort of transition activity or intention. So this could be literally sitting in your car, in the driveway for five minutes before you go inside and really be intentional and almost like visualize maybe okay, I'm putting my work self or my running around self away for the night. I am home now, being really present noticing that transition. But I also think too, closer to bedtime, try to have some mind clearing time. So, there's probably people that are like, oh my gosh, I hear this all the time. I'm kind of tired of hearing it, but it just is so true, So at least 30 minutes before bed, try to be off of your phone. Try to not work on whether it's coursework or our work work or any maybe chores like for kids or adults. Try to really have that at least 30 minutes before bed be a sacred time.

Host: Yeah.

Caitlin Garstkiewicz, LCSW: For you.

Host: The phone thing is definitely tough. I think for, for many people, for me, definitely. But I have noticed, I've been kind of into like a night routine of tea and I'll sit down, I'll have my cup of tea and it is kind of a moment where I'm like, whoa. Hard reset, I feel kind of chill right now, you know? So yes, it's really greatly. It is great. And I think it does help with like getting ready for that bedtime kind of, kind of moment.

Caitlin Garstkiewicz, LCSW: Absolutely.

Host: Yeah. So what role do relationships and social support kind of play with managing stress that you've seen?

Caitlin Garstkiewicz, LCSW: Yeah, yeah. When I had seen that was one of the questions that we would probably connect on, I was both excited and also my instant response was it has everything to do right. And again, kind of connected to sleep, our relationships and social supports, and stress can potentially be a two-way street. Which can be frustrating and can definitely impact like our mood overall. Right. And if we have a longer term challenge with our mental health or any sort of sadness or anxiety, but having positive relationships and consistent social supports and not even just the, okay, I have my built in biological family, but really supports that speak to us that are supportive, like in our essence is, really important. So, it is a very difficult thing sometimes to bring attention to if we do have relationships that are stressful, or are harming us in some way. But, definitely prioritizing the relationships when we feel a little bit more maybe balanced or at a better baseline when it comes to stress.

Because it can be hard. Like we oftentimes want to isolate when we're stressed. And so we need a balance. We need a balance of engaging and socializing and utilizing those supports. But then also too, like we do need to make sure that we're connecting with ourselves and slowing down. So, one thing maybe to keep in mind when it comes to relationships and stress, and especially if they can kind of be one and the same at times, is just remember that things aren't permanent.

If you have to take a step back from either a relationship completely, or take a step back just a little bit, right? Like, okay, I'm going to be off my phone a little bit more. Or, okay, I have a weekly call with my best friend and, I really need to prioritize myself. Just remember that things don't have to be permanent. And, just listen to yourself.

Host: Yeah, I think that's really good advice. Keep making sure that you're listening to what you need. Because even person to person, you're going to be different and day to day, you're going to be different on how much you need from others. If someone wants to start building better stress management habits, like today, I know you gave us a few tips, but like, what would you say this is the number one simple step you recommend to take as a first step?

Caitlin Garstkiewicz, LCSW: Yes. My number one recommendation would be find a 10 minute period in your day, and if it can't be every day, then start at an amount that feels approachable. But a 10 minute period where you are just showing up, that is the only intention. The overall intention's going to be okay, this 10 minutes is going to lead me into better practices or lead me into taking care of myself or bringing attention to some of the things that have been hard for me to manage.

But when it comes to stress and coping skills, taking care of ourselves, we also have the like physical element of habit. Habit as humans can sometimes not be on our side. Yeah. It takes some time, right? So I think that having a small amount of time that you really, just from a slower space show up for yourself to say, okay, I'm just going to get started, so I'm going to start with my 10 minutes.

And if for the first couple of times it's like, okay, I'm just going to set a 10 minute timer and I feel kind of lost, not quite sure where to start, that's okay. But getting into the habit of making that time for yourself, is pretty imperative. Because that usually is the hardest thing.

 And then starting slow, right. Like, don't try to change your whole life in that 10 minutes. You know? But definitely find 10 minutes a day, or at least three times a week that you can just slow down and start showing up for yourself.

Host: Yeah. What's an example of, like, what would that 10 minute time look like for you?

Caitlin Garstkiewicz, LCSW: Yeah. Yeah. So, for me personally, I think that keeping my thoughts organized is a big stressor. So, for me, a good place where I would start is just using that 10 minutes to coordinate kind of where my thoughts are at. Right. So, but I think overall that 10 minutes can be okay, I'm feeling very stressed and my body's starting to feel tense. Okay. Well that, that sounds like a cue that maybe we need to just concentrate on being slow. Maybe doing some light stretching, some affirmations, encouraging yourself. Sometimes it might be okay, I'm real, I've, identified that finances are my biggest stressor.

Okay. Well then it sounds like for our 10 minutes at least for maybe a couple of weeks, I'm going to spend those 10 minutes a day towards bringing attention to my number one identified stressor of finances. Right. So, we can definitely use it differently from time to time, but just making sure that we stay connected to the intention or what we need in that time.

Host: Yeah. I feel like that's really great advice. You don't really think of scheduling time like that. But I can see moments where I would do it for exactly that, for like, oh, I feel like I'm overwhelmed by this thing. And it's better to face it and to do that little at by at a time. And you'll feel better from doing it, right?

Caitlin Garstkiewicz, LCSW: Oh yeah, absolutely. And, and I think like a really big thing too that we might hear, is like, oh, I'm feeling better. So then I just stop doing these things that we've started. So, I think that starting with that 10 minutes, no matter what, is a great place to start. So then we even long term, make sure that we stay committed. And I would really suggest keeping that 10 minutes. And of course ideally it it can grow a little bit, right. Ten minutes a day isn't necessarily all that we need. But it's a great place to start and make sure that we keep showing up.

Host: Yeah. So if someone kind of starts doing those things and they're kind of noticing that maybe they need a little more help than that, their stress has maybe reached a point where they need professional help, for them or their families; how can they identify that?

Caitlin Garstkiewicz, LCSW: Yeah. So similar to what I had said earlier about when we had talked about specifically what is stress and the idea that we all experience stress differently. My baseline is definitely going to be different than your baseline and then the person next to us, right? And it's, it is impacted by how stress was talked about or presented, or modeled to us as kids and growing up.

It definitely depends on if we have a trauma background or what type of experiences we've had, and also too our access to resources impact that. Right. So, I want to start off by saying that everyone's sign for okay, I, need to maybe start getting professional support might look different.

 But I would say the biggest indicator is when we've noticed that there is one or more part of our world and our day-to-day life that's becoming impacted. So if we start noticing that I am avoiding certain tasks or I'm wanting to call in more often to work, or if we start isolating, or sometimes it's some of us show stress through, we are, we're getting a little bit more impulsive, so kind of saying, I'm not really interested in this anymore. I think that those are really big indicators when we notice that there's one or more element of our life, that is being impacted.

But then also too, I think the extent right? Or, the consistency of that. So if, we notice that, okay, it's been two months and I'm not really noticing a big difference. That definitely I think is a sign that, hey, let's, let's get some support. Because the thing with stress is too that, it can just exasperate kind of out of nowhere or it feels out of nowhere.

Right. Because we're just in the grind. We're in survival mode even maybe. So it can be difficult to spot and know when we do have that need.

Host: Definitely. Well, I think that's all really, really great advice. Is there anything else that you'd like to add today?

Caitlin Garstkiewicz, LCSW: I would just say prioritize yourselves. Prioritize yourselves. The world is a hard place and, right now we're even experiencing like, almost like societal trauma. Like the world is, pretty wild right now. And so, I would say that everyone, even if we feel that we're in balance or that things are okay, take a moment to really ask yourselves like, am I okay?

Like, when do I feel my best? When's the last time I felt excited or maybe even awe, like that feeling of awe, because those are the moments that we really need as humans to keep going. So prioritize yourselves and even if you feel like I'm good, take a moment for yourself and really ask yourself those hard questions.

Host: I think that's awesome advice. Thank you so much for joining us today, Caitlin.

Caitlin Garstkiewicz, LCSW: Yes, thank you for having me.

Host: Yeah. And thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.