This week on Calling in Sick, I'm sitting down with Patrick Casale — licensed clinical mental health counselor, TEDx speaker, host of Diverging Conversations with Dr. Megan Neff, and someone who found out he was autistic at 35.
If you're chronically ill, neurodivergent, or living at the intersection of both, this one is going to hit. We get into what happens when the world's box is simply not built for your body or your brain — and what it costs to keep forcing yourself into it anyway.
We're diving into:
🧠 Autistic burnout is NOT workplace burnout — you cannot fix it with a four-day weekend or a spa vacation, and Patrick explains exactly why
🎭 The masking bill comes due — scripting small talk, mimicking facial expressions, not knowing what to do with your hands, and the fatigue that follows
🔍 Diagnosed at 35 — the internal ableism, the imposter syndrome, and the "grief-relief paradox" of finally having a name for your whole life
⚡️ "An exposed nerve ending going through life" — the line a friend said to Patrick that reframed everything
👋 The great friend shedding — why people say "you're always sick now," and how you find the ones who move to the shade for you
❤️🩹 Reparenting your inner child — the fidget toy, the little girl at a 100 person dinner, and repairing the kid who never got support
We also go WAY down an Anthony Bourdain rabbit hole, because of course we did.
xx, Alex
💬 Comment: tell me about the person in your life who accommodates you without ever making it a “thing”.
TIMESTAMPS:
Intro:
00:00:00 Welcome back to Calling in Sick! (Ft. Patrick Casale)
Patrick Casale:
00:04:43 What is autistic burnout? (And why a spa weekend won't fix it)
00:07:50 Introduction to Patrick — background, career + the ADHD diagnosis
00:18:34 Pursuing an autism diagnosis at 35 — masking, assessment, disclosure
00:29:00 Coming to terms with autistic identity (the grief-relief paradox)
00:31:55 Internalized ableism
00:35:52 The great friend shedding
00:43:55 Reparenting your inner child
Conclusion:
00:47:07 One Brain Cell Show: Apple TV, cooking competitions & comfort rewatches
00:53:03 Where to find Patrick
00:54:15 Thank you for listening!
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Stay connected and follow us on socials for more!
• Instagram - https://www.instagram.com/callinginsickpod/
• TikTok - https://www.tiktok.com/@callinginsickpod
• Facebook - https://www.facebook.com/profile.php?id=61558234607568
• Substack - https://substack.com/@callinginsickpod?
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/
#AutisticBurnout #LateDiagnosedAutistic #ActuallyAutistic #Neurodivergent #AuDHD #Masking #Unmasking #InternalizedAbleism #ChronicIllness #Dysautonomia #SpoonieLife #InvisibleIllness #DisabilityAwareness #NeurodivergentEntrepreneur #PatrickCasale #MentalHealth #CallingInSickPodcast #AlexWildeson
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