This week on Calling in Sick x Ask Alex, Patrick Casale is back — and we're getting into the overlap that almost nobody talks about - living at the intersection of autism and chronic illness.
Patrick found out he was autistic in 2021. At almost the exact same time, he started choking on his food, regurgitating, waking up gasping. For nearly a year he was told it was acid reflux. Or GERD. Or — say it with me — anxiety. Have you tried mindfulness? It turned out to be Zenker's diverticulum, a condition affecting a fraction of a percent of the population, most of them over 65. Sound familiar?
We're diving into:
🫁 Patrick's diagnostic odyssey — a year of being disbelieved, and the one provider who finally said "you sound like you have this really weird condition"
🧠 Why autism, ADHD, POTS, MCAS, hEDS and chronic fatigue keep showing up together — and why nobody's connecting the dots for you
🚩 The gaslighting-to-self-gaslighting pipeline — how being dismissed enough times teaches you to dismiss yourself
📋 Interoception, people-pleasing & underselling — why you say "a 4" when it's really a 12, and how that delays your care
🎤 Rapid-fire online stereotypes — "ADHD is just a lack of discipline," "you don't look autistic," "everyone's a little bit autistic," "getting accommodations is cheating," "everyone experiences burnout." Patrick gets the mic drop on all of them.
🎭 The masking conversation nobody's having — why "just unmask!" is a privileged take, and when masking is genuinely the right call
♿️ High vs. low functioning — why "high functioning" is not a badge of honor, and how it lands you in burnout
Plus: accommodations are your legal right, not a favor. Stop asking. Start telling.
xx, Alex
💬 Comment: what's the "ism" you're most tired of hearing? I'll add it to the list.
TIMESTAMPS:
Intro:
00:00:00 Welcome back to Ask Alex! (Ft. Patrick Casale)
00:00:25 Patrick's chronic illness diagnosis (Zenker's diverticulum)
Patrick Casale:
00:04:06 Finding the right provider — and the moment you believe yourself again
00:08:44 The crossover of autism and chronic illness
00:13:20 Tips for navigating care (interoception, people-pleasing + reference docs)
00:16:20 Rapid fire online stereotypes (self-diagnosis, masking, burnout, etc)
Conclusion:
00:36:10 Where to find Patrick
00:37:20 Thank you for listening!
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• Instagram - https://www.instagram.com/callinginsickpod/
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Connect with our guest, Patrick Casale, MA:
• Instagram - https://www.instagram.com/patrick.casale/?hl=en
• TikTok - https://www.tiktok.com/@patrickcasale
• Podcast (All Things Private Practice + Diverging Conversations with Dr. Megan Neff) - https://www.youtube.com/c/allthingsprivatepractice
• Substack - https://patrickcasale.substack.com/
• Website - https://www.allthingspractice.com/freebie-vault-2026
• TedX Talk - https://www.youtube.com/watch?v=hyImqW69OY4
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Produced by: Alexandra Wildeson — https://www.instagram.com/alexandrawildeson/
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