In this episode, I sit down with therapist, entrepreneur, retreat host, and fellow neurodivergent human Patrick Casale to talk about something we don’t sugarcoat enough: autistic burnout, ADHD burnout, addiction, masking, and what happens when a “successful” life becomes unsustainable.

Patrick has built an incredible career—international retreats, multiple podcasts, coaching programs, and a group practice—yet behind the scenes he’s been navigating 18+ months of deep autistic burnout. We unpack the tension between ADHD-driven dopamine chasing and autism’s need for sensory regulation, the grief that comes with saying no, and what it really means to honor your capacity. This one is raw, honest, and real.

Patrick Casale, MA, LCMHC, is an AuDHD TEDx speaker, therapist, podcaster, and entrepreneur. He’s the founder of All Things Private Practice LLC and Resilient Mind Counseling PLLC, a group practice in Asheville, NC. As a neurodivergent business coach, he leads international retreats and summits helping entrepreneurs navigate impostor syndrome, self-doubt, and perfectionism while embracing authenticity. He coined the phrase “Doubt Yourself. Do It Anyway.”™

He hosts the All Things Private Practice Podcast and co-hosts Divergent Conversations. Patrick lives in Asheville with his wife Ariel and their very neurotic (but lovable) Shih Tzu, Hudson. He loves travel, Lord of the Rings, Anthony Bourdain, red pandas, cold brew, and craft beer.

Episode Highlights:

[2:26] – Why hearing his own bio feels overwhelming in burnout

[3:29] – What 18 months of autistic burnout has really looked like

[6:12] – High masking, high achievement, and hidden shutdown

[9:41] – ADHD vs. autism burnout: dopamine chasing vs. sensory overload

[13:33] – Grieving the “dream job” that no longer works

[14:13] – The origin of “Doubt Yourself. Do It Anyway.”

[17:14] – Deconstructing hustle culture as a neurodivergent entrepreneur

[26:30] – ADHD diagnosis first, autism later: identity and missed signs

[29:55] – Burnout vs. nervous system overload

[35:25] – Special interests as a burnout barometer

[39:54] – ADHD, dopamine, and addiction

[45:26] – Practical regulation tools before burnout hits

Links & Resources

TEDx Talk: https://youtu.be/hyImqW69OY4?si=yeo1bjgn5rvcx0AM
Instagram: https://instagram.com/patrick.casale
Website: https://allthingspractice.com
All Things Private Practice Podcast: https://www.allthingspractice.com/all-things-private-practice-podcast
Divergent Conversations Podcast: https://divergentpod.com

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The Cost of High-Masking AuDHD: Navigating Burnout After Success