I’d originally planned to go in May. Instead I went to Savannah to be with a friend going through a cancer diagnosis. So when I finally book…

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In this video, I’m talking through all the complexity of closing out a decade. This is not the tidy, inspirational version…this is the honest, off-the-cuff how I’m honestly feeling version.

I get into my complicated relationship with birthdays and holidays (something I understand so much better now that I know I’m Autistic and ADHD, can you relate?). I talk about running myself into the ground. And I open up about the three-day birthday my wife and my friend Ariel pulled together, how loved I felt, and how I still sometimes feel like there’s an invisible force field keeping me just far enough from the people who care about me.

I talk about the grief I’ve been carrying this year. About boundaries, reducing demands, and the constant tug of war between what my Autistic self needs and what my ADHD brain craves.

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I talk about deconstructing the “never good enough” story I’ve carried since childhood, and how that work is a long road that doesn’t magically end at 40. I talk about the tension of being a creative person who can’t fully power down, and about finally giving myself permission to be exactly who I am. Nerdy, intense, deeply interested in the things I love, and embracing all of it.

I don’t have this figured out, and this isn’t a how-to. What I do have, at 40, is a couple of core truths.

• Recovery is possible.

• Nuance matters, because almost nothing in this life is binary.

• And the only things you really get to take with you are how you feel about yourself and how the people closest to you feel about being in your life.

If any of this sounds like your own life, whether you’re late-diagnosed, chronically ill, in recovery, deep in burnout, or just trying to figure out what it means to take up space as yourself, I hope you’ll watch or listen to the full episode. Save it for your next walk, your commute, or while you’re making dinner. And if something rings true for you, tell me below. That’s what this space is for.

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As always… Doubt Yourself, Do It Anyway.

Patrick

🎧 On Repeat
I keep playing “Heavy” by Kiara and Linkin Park on repeat, which is probably indicative of my mood and mindset. Such a painful yet beautiful vulnerable song about people who are suffering publicly but continuing to try to fight on despite the heaviness that we carry.

📺 On My Screen
I’ve been in major rewatch mode of both Shrinking and Ted Lasso, especially in anticipation of season four of Ted Lasso coming out this Summer. I cannot freaking wait and it is such a comfort show for me. Shrinking is so beautifully written and created. The acting is phenomenal. As a mental health therapist I laugh at so many of the scenes of things that a lot of us want to do and the connection and community and sense of belonging is just outstanding.

🍔 On My Plate
While in Ireland, despite the fact that it was 95° every day and miserably hot, I probably ate no less than 15 different soups. Soup is one of my favorite comfort foods and Ireland really nails it in terms of soup that you can just get at a pub with a hunk of brown Irish soda bread next to it. Absolutely delicious.

🌀 How did you cope with being away from home for so much of the month?
Being in Ireland for almost all of July, it was a beautiful reminder of how hard it is for me to transition into new environments, new accommodations, new places to stay,

and to get comfortable in my surroundings. While I’m traveling I often yearn for home and the familiarity of my bed, my couch, my dog, my wife, etc., but also enjoy the fact that I had so much new stimulation all around me.

💬 Words That Landed
A friend reached out to me to give me permission to have a difficult time while traveling in Ireland. I felt so guilt-ridden that I was having such a difficult time due to the intense heat wave that they were experiencing. The quick reminder of what I

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I have spent so much of my life feeling like an alien. Like I don’t belong. That I can’t connect to the world around me. That there is something wrong with ME. I hope these stories help you feel a little less alone......

Because when I connect with someone over a shared, special interest, and am able to deep dive, it feels like time and space cease to exist. And it’s important to talk about our strengths in a world that wants to focus on our struggles, you know?

I think that special interests are a gateway into the Autistic soul. Anchoring into special interests allows for us to not only regulate and sensory seek, but to unmask, and connect in a way that feels natural, authentic, and meaningful about things we are truly passionate about.

I’ve come to learn that object based communication works really well for me instead of social based. talks about object based vs social based conversations a lot. Being able to think and connect over topics, ideas, and shared interests is a much easier entryway than muddling through small talk. “How are you feeling today,” is one of my least favorite questions of all time.

I thrive on context. I want to go beyond the surface questions. I need depth.

Travel for me often allows me to access the most authentic version of myself.

I tend to connect with random strangers everywhere I go. Some of it could be because I probably won’t see them again. But, I think it’s because you can dive right into deeper topics without the artificiality of small talk.

I was just in Ireland solo for almost three weeks. During that trip, I had 10 different social situations that were unbelievably meaningful to me. Conversations that will stay with me forever, allowing me to completely destroy the stereotype that Autistic people “can’t be social or connect.”

I went on a Celtic mythology tour one day and ended up connecting with a very shy man from Poland. He was a teacher and a historian and we ended up pub hopping through Galway. When we started talking about his special interest of medieval European history, he lit up and became a completely different person. All of a sudden he was talkative, confident, and charismatic.

The quiet man who was on the tour was now replaced by someone who was so passionate about his interest, that he could have talked about it for days. It was unbelievably fascinating. During the entire time together, we didn’t even share our names. It wasn’t important. We just dove into the depths of special interest conversation.

A few days later, I was on a tour in Killarney and I randomly started talking to a group of women from the states about their careers. We ended taking the tour together and discussing all things neurodiversity. They told me about their family members whom they thought were Autistic, and picked my brain on diagnosis and discovery all day.

One of them was a teacher and told me about all of the ways that they try to build in an inclusive classroom environment for their students, especially those that they knew or could tell were clearly Autistic or ADHD, and struggling. The conversation was beautiful and affirming.

Then, a few nights later, I was wearing an Autism t-shirt that my friend made, and was approached by a couple at the pub. The man immediately started the conversation by asking, “Did you know that Killarney is one of the most Autism friendly towns in Ireland?” He then told me that he had recently been diagnosed, at age 59.

We spent the next two hours talking about our lives, our struggles, our special interests, and more importantly, about our own shared experiences. All because I was wearing a t-shirt that made him feel safe enough and comfortable enough to approach and immediately dive into a conversation. No forced social niceties or pleasantries needed or expected.

During my final days in Ireland, I took a private, Irish wolfhound hike through The Burren. Animals are a special interest of mine, and I try to find as many animal filled experiences as possible when traveling. The owner of the company and guide immediately started talking to me about how he has listened to my podcast and TEDx, and was excited to tell me about being a fellow neurodivergent entrepreneur.

For hours, we sat in the park, near the water, the 3 majestic dogs at our feet. Talking about life. Our own struggles with addiction. Discussing similarities in our AuDHD discoveries as well as struggles. It was such a beautiful, unexpected moment of connection.

I know that I am not speaking for every Autistic person when I share stories like these. I know I have an enormous amount of privilege and ability to unmask safely in most situations that I am in.

I also know that although there are very real struggles being Autistic, there are also so many beautiful moments. When I am able to intensely share, deep dive, and be curious, I am able to connect and belong, and feel like I am a part of a world that I often feel misunderstood and rejected by.

I’d love to hear some of your own experiences of connection and social “differences” in the comments, travel related or not. I’d love to read anything you’d like to share and I can promise you that you sharing will help at least one other person reading along.

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Until Next Time,

Patrick

A quick note: this video was recorded a few months ago, so some of the specifics may feel dated. But the intensity of what I was feeling (and still feel) hasn't gone anywhere.

It’s really hard right now to be a human. And I’m 100% certain it’s harder for people who don’t look like me. If you don’t have the privilege of being a cis het white man, it’s heavier. It’s harder.

In this video, I’m talking about what it’s like to try to hold space for a community, a staff, a family, when I don’t have the answers myself. I own a group therapy practice. I employ 25 people. I’ve been worried about their livelihoods since COVID, and then we went through Hurricane Helene here in Western Carolina — collective trauma times a million. I have trans therapists, Autistic therapists, Black therapists, people with marginalized and intersecting identities on my team, and it’s hard to lead right now when I can’t promise anyone that it’s going to be okay. Because I can’t. There’s not a lot we can control right now besides ourselves, our community, and the people we care about.

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I talk about the communal dread so many of us are feeling — the catastrophizing, the worst-case-scenario thinking, the fatigue of trying to still access joy when joy is a form of resistance and the world feels like it’s on fire. I don’t hold back about how scared people around me are right now, including someone in my own life who’s afraid to leave her house.

I get into what I’ve watched work, both during COVID and during Helene: community. Collective action. People checking on each other. Sharing resources. Helping each other regulate through the uncertainty, even when we don’t know the outcome. I talk about the guilt that comes up when you can’t show up in the ways you wish you could.

I also talk about being Autistic and ADHD, and about the pattern recognition that let me see some of this coming years ago, back when people told me I was being dramatic. I’m not saying that’s true for everyone in this community (it’s definitely not a binary) but for me, it’s been real, and it’s been lonely to sit with.

This isn’t a how-to video. I don’t have the answers. What I do have is the belief that we get through this together, not by siloing ourselves off from each other. I hope you’ll watch or listen to the full episode or bookmark it for your next walk or commute.

And if something in this resonated with you, whether you’re a therapist trying to hold it together for your clients, or you’re just trying to figure out how to exist in the world right now…share below. That’s what this space is for.

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And if you know someone who needs to hear that they’re not alone in this, send this their way.

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As always…Doubt Yourself, Do It Anyway.

Until next time,

Patrick

Travel never goes the way that you think it will. It will often be messy and chaotic and unpredictable. So many times I have this idea and version of what my trip and travel will be like and it almost always lets me down. I love planning trips and I love fantasizing about the person that I will be and how I’m going to experience it. And I also acknowledge that almost every single time that I travel it never really feels the way that I think that it will, which can often feel like such a gut punch and major letdown.

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Then I grieve the fact that it is not the experience that I wanted nor needed. As I’m going through the struggle and the anguish and suffering of this Ireland experience in general because of the heat and my inability to sensory soothe and get comfortable, I start to break down emotionally. I really wanted and needed an environment that was cooler in weather and temperature compared to the United States. My entire goal of getting out of there in July was to avoid our hottest weather month and to immerse myself in a place where I could finally feel comfortable in my body and being out in the elements. And, because of global warming, Ireland is experiencing a massive heatwave, one that is almost unprecedented for the majority of the country. It’s certainly not Ireland’s fault that it’s this hot and it’s not my fault for traveling here during this time. But it still fucking sucks and it still feels like a letdown. Although I’m having a good time in small doses, the majority of the time I’m feeling very overwhelmed and feeling very dysregulated.

It’s such a privilege to be able to travel the world and I have had more opportunity than most and I am so fucking grateful for that. And like the late great Anthony Bourdain says, “Travel will often break your heart.” This Ireland trip is really testing and trying me because I am trying so hard to be grateful for the experience and for being able to have the autonomy and freedom to do this. At the same time I am really struggling throughout each and every day.

I romanticized what it would be like to live at that off-the-grid cabin in the middle of the woods in an animal sanctuary and I really wanted to make it work. No Wi-Fi, a compost toilet, a shower that only worked by the way of sensor, and completely remote and off the grid. Last night I set up the hammock and read a book outside under the stars, just me and the animals and nobody around for miles. It was really lovely last night and because the weather dropped down by about 30°, it was so comfortable to be outside just existing with absolutely no care in the world. And then today, it is a completely different experience because of the heat wave.

It’s 95° today so it’s all kinds of rough. Honestly I’m enjoying the mornings and the evenings but it’s really hard for me during the day. They said this is the worst heat wave they’ve experienced in this part of the country in over 30 years.

It is honestly a bummer. I am still having fun to some degree, but my body is unable to truly relax and reset because I am overheated and overwhelmed the entire time. The expectations and hope of what we want a trip to be vs. the reality can wreak havoc on me. And then, there’s the guilt of not fully enjoying it while also acknowledging that I am on “vacation “ in Ireland. A place on many people’s bucket lists. That is certainly not lost on me at all.

I NEEDED this trip to be different. It was not about vacation for me, but actually getting away from the intense heat and weather.

It kind of sucks because I was supposed to be here in May and instead decided to go support my good friend, Chris, which I have no regrets about whatsoever, but that season would have been more of what I really needed from this experience. This particular experience is testing me whereas I needed it to be comforting and regulating to me.

It’s okay though. I’m gonna try really hard to anchor into the good moments that I’m having too. I’m just having a rough day. I did not sleep well in that cabin. It is so hot outside that there’s nothing to do and because I’m in that cabin in a sanctuary with no Wi-Fi and no access to anything, I basically have to just go into town and sit at a pub. I certainly don’t mind doing that but I want to do that in the evening time and not all day.

I was supposed to be changing rentals after a couple of days in the cabin, to an Airbnb in the middle of town, right on the sea. However, because of the heat, I moved it up to today. This brings up a whole other set of emotions, like, “see you can’t even have this type of relaxing, off-grid experience.” The cabin itself is basically like one big sauna. It soaks up all of the sun outside and because there’s no way to cool it down, it actually almost reached 110° today. I almost ended up having a heat stroke and had to leave immediately. I called my wife to help talk me through the experience so that I didn’t leave more stuff behind and so that I could regulate my nervous system without having a panic attack.

More and more, I think that I realize that I want to be the type of traveler/human that I am not.

There is such an enormous amount of vulnerability when traveling solo and all alone. We’re going to navigate these big heavy conversations and emotional experiences that transpire all by yourself. Sometimes I think this builds resiliency and character and other times I feel like it’s just fucking painful.

There are so many instances in my life where I’ve been traveling, oftentimes solo, and have completely shut my trip down days, if not weeks, early to go back home. It often feels like defeat. The money that goes into traveling, all of the energy, all of the time away from home, constantly chasing this feeling of just needing something to be different, chasing comfort and a sense of ease. Even now while laying here, having six days left of this trip, I’m already thinking about cutting it short because of the weather.

This is a thought that is on my mind pretty often. The amount of money that I’ve lost from vacation rentals, flight changes, and cancellation fees is astronomical. Coupled with the amount of guilt and regret that comes with constantly reshuffling and rearranging experiences, it can create such an enormous tax. All of my life I’ve just wanted to feel comfortable, to feel like I could be long and exist demand-free and I’ve been chasing that feeling for almost 40 years.

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As I sit here, sunburned in Ireland and overwhelmed, thinking about flying home early, I already know that I would lose hundreds, if not thousands, of dollars on vacation rental fees that can no longer be refunded due to cancellation policies. Of course when booking I never think that I’m going to cancel or leave early or rearrange my trip. In the moment the exhilarating feeling of travel planning and being somewhere else overwhelms my pre-frontal cortex.

Until Next Time,

Patrick

And then I saw it. The casino that I had gone to 20 years ago during my first trip to Ireland with my family I had snuck out of my room that night without telling my dad where I was going and with my last €100 to my name I took a cab to that casino. I never thought about the fact that if I had lost all my money I would never know how to get back to my hotel. I would never be able to afford a cab or a taxi. I would have had to walk miles in the cold in the middle of the night. But that’s what addiction does: it completely clouds your judgment, making you unable to actually rationally think. Impulsivity and recklessness take over and the only thing that you can think about is the act or the usage or the process or the drug.

I saw the sign that said casino and a thought flashed through my head. I thought to myself, “I haven’t gambled since June of 2012. Maybe I could gamble and actually control it this time.” The fantasy immediately kicked in and I started to romanticize what it would be like to actually gamble in a casino again. The exhilaration, the fun, the enjoyment, the risk taking. I could almost hear the roulette ball spinning around the wheel or the card shuffling in a musty, cigarette-filled dark casino room. I started to think about how the last time I was in this casino, over 20 years ago, I had won over €10,000 off of that €100.

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I remember that memory all too well: hitting number after number on roulette, increasing my bet to the point where the casino owner had to come and stand next to me because he believed that I was cheating. I remember playing limit poker that night and winning hand after hand. By the time I knew it, I was asking the owner to cash my chips out and he had to go to a back dark room and pull money out of his own individual safe. I asked him if he could call me a taxi and he told me to get fucking lost and to get the fuck out of there, shoving the crumpled up money into my chest.

I then quickly realized that I was in a dangerous situation and the fog of my addiction had lifted, allowing me to think and see clearly for the first time in hours. That’s what happens during addiction. You cannot rationally think straight or make good decisions. Everything that you’re doing is to feed that, stoking that fire, and fanning the flames. It’s like getting a gremlin wet even though you know you shouldn’t. Before you know it it’s completely out of control and you’ve mortgaged your home, your car, or you’ve decided to partake in criminality to feed the addiction and to get one more high.

I sat in front of that casino door last night for a good ten minutes staring at it. Thinking about how long it had been since I had last gambled in the casino that was in the mountains of North Carolina. Scenario after scenario flashed through my head, all of which ended in glory and exhilaration.

But something’s different in me now whereas I had no control over this addiction 15 to 20 years ago. Now I was able to step back, regulate myself, immediately start walking away, and I reached out to several friends, including my wife, to let them know what was happening. I let them know the thoughts that I was having and that I needed their support to help me stay accountable to going to dinner and not backtracking. I asked them to make sure to check in on me after dinner so that I would go immediately to my hotel room instead of going back to that casino. They all said yes and they all helped me get through that moment, something that would not have happened several years ago back in the day.

This is the reality that we live in. Triggers and urges are EVERYWHERE. Whether you are recovering from addiction, or you are trying to actively avoid or maintain abstinence over something that has had such control over you, it’s important to know that your fate is not pre-determined.

There are lots of ways to avoid a relapse when you are in recovery. There are so many different tools at your disposal. But you do have to be prepared to come face to face with this demon that you have been successfully avoiding for so long. It always seems to happen out of nowhere when you’re least expecting it or ill-prepared.

I was in a very vulnerable state last night. Not only had I been drinking with someone who I had met on a tour that I went on, but I also was experiencing some intense loneliness and overwhelm from being an AuDHD human traveling through the world. It would have been so easy to reach for something to give me a temporary fix or relief but it always would have been a band-aid, never a long-term solution. In the past I absolutely would have done that and I would have been picking up the pieces for the next couple of weeks, if not years.

My wife reminded me last night that if I started gambling again, I would lose everything, including her, our dog, and our home. I have a lot to lose these days and that is definitely not something I could have said 20 years ago. I know that even if I had tried to gamble last night successfully and was able to control it to some degree, my brain would have then convinced me that I could do it again. Just like the domino effect each piece would start to fall, laying the path to self-destruction.

I am very proud of myself for how I handled last night. It definitely could have gone very differently. I also know that when we are in more vulnerable states, it is so much harder not to succumb to this temptation. It would have been so easy to go into that casino and completely shut out the outside world for the foreseeable future. Hours would have turned into days. Days could have turned into months. Everything that I have worked so hard for from my abstinence date of June of 2012 would have come crumbling down like when Frodo throws the ring into Mount Doom (technically Gollum did this).

I started to think about everything I’ve worked so hard for, including:

• my marriage of 12+ years

• my master’s degree in clinical mental health counseling

• the 2 businesses that I own

• the friendships that I have

• my self-respect and self-worth

• all of the things that I did not use to have access to

I want you to know that we do recover and that it is possible. There is a light at the end of the tunnel no matter how bleak and dark things seem right now. I also want you to know that triggers and urges are everywhere, and unavoidable. I know too many people, myself included, who have tried to create this facade or fantasy world where we completely avoid triggers and urges in every area of our lives. This feels to me like white knuckling through recovery and not actively participating in a recovery plan that is actually healthy for you.

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I know that I’m able to handle this now with a lot more resilience and that it has taken me years to build up that strength, courage, vulnerability, and the ability to reach out for support.

We do recover. It is possible. You deserve to live and heal.

Until Next Time,

Patrick

📎 A quick note before we get into it: Videos on AuDHD Journeys are now free for all subscribers. No more paywall. I want these videos to reach the people who need it. If you’d like to support this work financially you can become a paid subscriber (see the new perks here) but please know that your comments, shares, and likes are the best support I could ever imagine. I’m so grateful you’re here.

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There’s a cottage. Mine is in the middle of Ireland… rolling green hills, sheep and donkeys, no WiFi, no phone, nobody who can reach me. I go outside and just exist out there. Nothing can get in.

I think about that cottage every single day.

In this video, I’m talking about the fantasy of disappearing, and I need to be clear about what I mean, because it matters. I do not mean ending my life. I mean disappearing from the demands of existence. I wish we could talk about all of this without the shame and stigma that assumes ideation always leads to action. No judgment if you’re struggling with that, because it’s a real part of a lot of Autistic lives and deserves to be spoken about openly. But the fantasy I’m describing is the one a viral post of mine hit a nerve with: thousands of comments, something like ninety percent saying yes, that’s exactly it, and I can’t explain it to anyone without them thinking the worst.

So I want to look at what that cottage is actually made of. Because it isn’t really about Ireland, you know? People live in Ireland and feel exactly how we feel. It’s about a nervous system that’s been pouring over its edges for years. The capacity bucket already overflowing, no room left, and then another email, another text, another ask from someone you love…each one minor, all of them compounding until the load is unbearable. And then the shame on top of it, the internalized ableism that says you should be able to manage these small things, when the truth is they were never small and you were never failing. Of course the woods start to look like relief.

But here’s the turn I want to offer. The cottage is data. Everything you build it up to be in your mind is telling you something true about your real life. So let yourself build it , visualize it, and write it down. Then read it back as a list of non-negotiables. If there’s no social media in it, that’s a step you can take this week. If it’s full of animals, get to the farm. You don’t have to walk off down the Appalachian Trail to get what the fantasy is pointing at. The fantasy isn’t the problem. It’s a map. I hope you’ll watch or listen to this full episode, or bookmark it for your next walk or commute.

And if something in this one resonated for you, I’d love to hear about it. Whether you’ve got a cottage of your own you mentally visit every day, or you watched this and finally felt less alone in it, share below. That’s what this space is for.

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And if you know someone who’s been carrying this or expressed something similar, scared of how it sounds out loud to admit, send this their way.

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As always…Doubt Yourself, Do It Anyway.

Until next time,

Patrick

While doing so I continued to get sicker and continued to have to figure out ways to support myself financially. This is really challenging because as a content creator who has built and developed a large audience and who relies on said audience to pay their bills and is no longer able to keep up with the capacity and output from five or six years ago, it is a frightening experience.

Parasocial relationships are really strange to me. More people in this world know who I am than I will ever know who they are. Because I talk about my life and my struggles so intimately and so vulnerably, people feel like they are entitled to my energy or to be able to give me life advice or get frustrated when I do not respond or react in a way that they felt like I should.

It’s weird to hold the nuance and the duality of acknowledging that I am unbelievably grateful to my following and my audience. My career has been something I never dreamed of as a mental health therapist. I never sat in grad school in 2015 thinking this is where I would end up.

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And the retreats, the podcasts, the speaking engagements, the coaching programs, and all of the things that I have done and accomplished have destroyed me. Maybe it was seeking out validation and affirmation that I am finally good enough or that I can be proud of my accomplishments, a core belief of mine that I’ve been trying to dismantle and deconstruct since I was a child.

The reality is I’ve created a dream job that I can’t actively participate in and because I’ve destroyed myself energetically and neurologically, and now I reap what I sow.

I am starting to fall apart physically and emotionally. The mental aspect of chronic illness does not get discussed enough. The behind-the-scenes of having to navigate doctor’s appointments, specialty care procedures, while trying to maintain a single ounce of executive functioning and working memory as an ADHDer is fucking exhausting.

I am getting sicker every single day. I am feeling depleted, exhausted, and so far beyond my capacity. I feel like Bilbo Baggins telling Gandalf. I feel like butter that has been spread on too much bread, “I feel thin.”

I’ve always talked about my experiences and my struggles publicly and this was long before having an audience. I remember family members asking me why I talked about my suffering so openly.

“Aren’t you embarrassed?”

“Do you think you’re sharing too much?”

I always did so because it helped other people feel less alone and it was also simultaneously cathartic for me. I never intended for people to hang on every word or follow along or download and subscribe.

These are things that do not actually matter to me. I’ve never been someone who can just show up and market myself or promote myself in terms of feeling aligned with my values.

I have such a hard time showing up and using calls to action or hooks or trying to promote or market because it never feels natural and that’s not why I started doing this. But the catch-22 is this is also how I pay my bills…

Living in a capitalist hellscape as a chronically ill, AuDHD content creator. I turn down so many brand deals because they are not values-aligned and I turn down most collaborations that are paid despite the fact that I do need to pay my mortgage and for all of this medical care and everything else that I’ve got going on in my life. If I can’t stand 10 toes down firmly, I can not say yes.

And yet because I share so openly and so publicly, people feel entitled to show up in my DMs with advice or critique or frustration because I did or did not respond a certain way.

Having people comment and critique your entire life publicly or negatively review you is fucking painful. It’s brutal. It tears you apart and it makes you feel like shit.

All I really want to do is hide and disappear from the demands of existence, like I’ve said a million times. I just do not want to have to continue living my life in a way where I have to be present, where I have to show up, where I have to be visible, where I have to be perceived.

I know this feeling shows up for so many of us in different ways. Not wanting to go to the office, to school, to the grocery store…the list goes on. And when you start to break it all down, it just gets really fucking weird to think about the connection between being perceived and making money, you know?

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I actually had someone message me privately yesterday to let me know that my content about chronic illness feels disingenuous because I’m a content creator and they know that I’m monetizing it. They let me know that they struggle with chronic illness and there’s no way that I could be content creating and doing the things that I’m doing if I’m also suffering. As if they have no understanding of what a dynamic disability can look like. Like they forgot that energy and symptoms are always fluctuating.

These sorts of critiques sting and it’s fucking painful and it happens all the time. A million tiny cuts that constantly compound.

I’m as vulnerable and open as I can be on a daily basis, exposing my entire life to help people feel less alone, more understood, and like they have a reason to keep going.

Just because I talk about this stuff does not mean that you get to DM me and have access to me or that you get to treat me like an object or source of information without also acknowledging the humanness and the human behind the account.

To everyone who sends me messages and DMs and emails that I do not have the capacity to respond to, I appreciate you so much. The reason that I keep going and keep creating and keep showing up is because of all of the messages about how my content either helped someone they love, helped themselves, saved a life, or my content made them feel like they were seen and understood for the first time.

And it’s so easy to lose sight of that when you get these negative, hate-filled, troll-like DMs and comments. My RSD (Rejection Sensitivity Dysphoria) rages and makes me want to burn it all down to the ground.

This is always a good reminder that the people that you follow on social media are not necessarily your friends or your colleagues. Maybe you admire them. Maybe you like their content. Maybe you think they’re hilariously funny or that they provide great valuable information and insights. And that’s wonderful but, you also need to remember that they are human.

Until Next Time,

Patrick

Here’s how I got through June:

🎧 On Repeat
Shaboozey’s “A Bar Song” has been living in my head, plus “Born to Die” and “Good News.” There’s something about having a few songs on heavy rotation when everything else feels uncertain.

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📌 Need to Know: What’s Changing with Paid

Paid subscriptions are coming back and evolving! We want your investment to feel worth it and genuinely useful. Think of it as Autistic burnout and chronic illness support from a neurodivergent, chronically ill creator. See what paid subscribers get at the bottom of this post ↓

It started with Lord of the Rings. My wife was out of town, I dropped into deep monotropic focus, and I watched all three extended cuts back to back to back while I wrote. By the time I came up for air that night I had 50,000 words. I don’t think I got up to use the bathroom. I definitely didn’t eat dinner. I wasn’t writing a book. I was just doing what writing has always done for me: making sense of things, getting them out, putting words to an experience so somebody else might feel less alone.

In this video, I’m taking you behind the scenes of writing that book. It’s called So You’re Autistic… Now What?, it’s coming out with Balance, an imprint of Hachette, and the manuscript is due next March. I’ll say this plainly: I’ve talked about self-doubt and perfectionism and imposter syndrome my whole career, and this project has handed me more of all three than anything I’ve ever done, combined.

In this video diary I walk through how it actually happened, because almost none of it was a plan. I reached out to a friend who’d self-published, she sent me a laundry list of sequential steps, and my executive functioning said hell no and closed the tab. My brain doesn’t move in straight lines at all. It hops, it diverges, it goes from association to association…so those step-by-step guides just don’t work for me. In this video I tell you about what I did instead.

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I’m honest about the privilege threaded through all of it. I know that being a white guy with a master’s degree, a therapist with a large following, made navigating a traditional contract more possible for me than for a lot of people who could run circles around me and are more deserving of the space.

I talk about the role publishers play and bust the myth that they do the marketing for you (they largely don’t). That part is mostly on you.

I talk about the learning and unlearning. I’ve been Autistic my whole life and only found out at 35, and the four and a half years since have been a long deconstruction, moving toward the neurodiversity paradigm and away from the pathology one — thanks to people like Dr. Nick Walker, Sonny Jane Wise, Dr. Megan Neff, and Tiffany Hammond.

And I get into the why, because that’s the thing I have to keep anchoring into when I contemplate bailing, which is basically every day. A woman in her mid-seventies came up to me after a keynote in Alaska and said it was the first time in her life she’d felt understood, and asked if it was worth pursuing a diagnosis at her age. Yes. A million times over. Discovery can be life-altering and life-saving, because living disconnected from yourself, feeling defective or broken or like you never got the manual, is a heavy, exhausting tax on a person.

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This book, more than anything, feels like a love letter back to the kid I was. The one who felt lost and broken, who contemplated suicide, who got into alcohol and gambling, who was just trying to find his way. I think writing it will be some of the most healing work I’ve done.

This book is not the end-all of the Autistic experience. It can’t be. And this video diary isn’t a how-to video, though I do talk shop — self-publishing versus traditional, proposals, finding an agent who shares your values, building the plane as you fly it.

If you’ve got a book in you, the only real advice I have is: start writing. Not sequentially. Five minutes a day, and you’ll never actually stop at five. I hope you’ll watch or listen to the full episode, or bookmark it for your next walk or commute.

And if something in this one resonated for you, I’d love to hear about it. Whether you’re writing your own book, sitting on the idea of one, or you watched this and felt seen in a way you didn’t expect, share below. That’s what this space is for.

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If you want to be on the wait list for the book, let us know in the comments. We’re building toward a lot more as we get closer.

And if you know someone who’s been sitting on a book they’re scared to write, send this their way.

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As always…Doubt Yourself, Do It Anyway.

Until next time,

Patrick

Anthony Bourdain was so important to so many people, myself included. The way that he moved through the world and showed us things that we never thought were possible while doing so with such intentionality, authenticity, vulnerability, and the willingness to be curious.

Not just curious about the food he was eating, although he admittedly would be slurping on noodles right now while having an ice-cold beer in an alleyway in Hanoi, Vietnam. The fact that he realized that food was a bridge to better understanding one another.

“Travel isn’t always pretty. It isn’t always comfortable. Sometimes it hurts, it even breaks your heart. But that’s okay. The journey changes you; it should change you. It leaves marks on your memory, on your consciousness, on your heart, and on your body. You take something with you. Hopefully, you leave something good behind.”

Food has always been that for me. It’s more than just the meal that you’re eating. It’s more than the experience. It allows you to understand other people’s culture, to hear their stories, to get to know them in a way that you would never be able to access in everyday life.

Preparing food can be a gateway into the soul. People often show love by preparing meals for each other. Whether it’s a recipe that’s been passed down through families and generations or something that you’re experimenting with, the curiosity, the artistry, the passion, it’s all blending into one cohesive message.

Bourdain showed us a version of the world that a lot of the Western culture never gets to see. The beauty is in acknowledging that, regardless of where you live, what religion you follow, what race you’re a part of, what your beliefs are and ideologies. As human beings we all just want one thing: to belong.

“It seems that the more places I see and experience, the bigger I realize the world to be. The more I become aware of, the more I realize how relatively little I know of it, how many places I have still to go, how much more there is to learn.”

Episodes in Iran, in Haiti, in parts of the Middle East, in parts of Africa, parts of Central and Latin America, Far Eastern Europe, always on a quest to show the behind-the-scenes for us to feel like we are sitting around that table, getting to hear those stories, to be a part of that meal, to be a fly on the wall.

I always admired Anthony Bourdain for being so honest. His facial expressions never lied. You could see the anguish, the pain, the discomfort, the sense of not feeling like he belonged anywhere while simultaneously amplifying the beauty of what it means to be human and to exist in a messy, chaotic, overwhelming, busy life.

I think about Bourdain on a daily basis. I think about what some of his takes would be on what’s happening in our world and in our country. I think about some of the comments he would be making about some of the meals he would be sharing with his good friends Eric Ripert and other chefs and other humans that he’s met along his journey.

Bourdain has forever changed how so many of us travel and how so many of us place an emphasis on having experiences over things. We cannot take the things with us but the experiences are things that we can anchor into for the rest of our lives. Forever creating meaning and purpose and connection, allowing us to meet each other’s souls in a different hemisphere, a different country, a different restaurant or dive bar.

Anthony Bourdain was crucial to my Autism discovery. Again I’ve said many times before I am not saying that he was Autistic but there were certainly signs. I resonate so much with being so overwhelmed, like a fish out of water, even when we’re in our natural elements where we feel like we can finally zone in on the things that we feel passionate about. Always kind of existing on the periphery, never truly integrating and inserting ourselves. Always feeling that sense of distance, even when in close proximity to those who love you.

Bourdain was so much more than a chef and a food critic or a food travel host. He was a journalist. He was someone who was able to showcase that humanity is beautiful and humanity is also painful. The duality was something that I think he amplified and highlighted better than anybody else.

“Travel changes you. As you move through this life and this world you change things slightly, you leave marks behind, however small. And in return, life — and travel — leaves marks on you.”

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Black and Brown Autistic people who have an extra layer of marginalization, intersecting identities, often those who have been on the margins of society, who have been discriminated against and disenfranchised, having had to fight just to try to get equal footing in a world that tells them that they are not worthy or not good enough.

I look at my social media accounts and my following and acknowledge that the numbers don’t always seem to make sense to me.

The reality is though, I do my best to make relatable content that a lot of people can feel seen and understood by. I do put words and language to hard experiences to humanize experiences that often feel unique or rare.

My goal with content creation has always been to make people feel less alone. It’s cathartic for me to write this way, and it’s hopefully helpful for you to hear these things.

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However the reality is that my account and other people who have come into the Autistic advocacy spaces and the neurodiversity spaces over the last few years, who discovered that we were Autistic, ADHD, AuDHD, etc., later in adulthood, have taken up a lot of room, suffocating those who have already been there before us, laying the foundation, doing the work. Oftentimes we get it wrong.

An entire group of people who have been disenfranchised, pushed aside, or have fallen through the cracks then have to spend mental and emotional labor and energy correcting our mistakes or our misguided attempts to make Autism and ADHD something that it’s not.

I have zero doubt that a lot of my popularity and following has come from the fact that I am a white man with a masters degree. Algorithms push what they consider to be a more “palatable” version of what social media and mainstream media consider Autism to be.

Society and mainstream media basically say that if you look like me, if you have an education, if you have a career, if you’re producing or participating in capitalism, then you have some inherent value and therefore are willing to look past the Autistic side of things, and almost as if it’s an anomaly, or like, “yeah, but not you’re not like them.”

There is research showing that algorithms focus more on white faces, meaning that although I make good quality content, there are likely Black and Brown and moderate and high support needs, non-speaking, Trans and Queer Autistic people who have a lot more to say, with much more impactful lived experiences. People who have different perspectives and even more understanding about the scientific research on all things neurodiversity than I will ever have.

Yet they do not get the engagement that I get because they do not look like me because society has decided that I can be a face for the Autistic community. If I am the face of the Autistic community, then they can help normalize the Autistic existence and experience.

This also has come in the form of partnerships, collaborations, even the book deal that I received. Do I think I don’t deserve it? No. I think I’ve worked my fucking ass off and that I have a lot to say and that my perspective is valid and needed. However there are plenty of people who do not look like me who will never get these opportunities because all of these institutions have decided who they want to support and who they want as an Autistic representative.

I would be lying to myself and to everyone else if we didn’t realize and acknowledge that white privilege in this society is very, very real. Especially in a society that is institutionally and inherently racist. It also means that other people who don’t look like us have to scratch tooth and nail and fight with everything they can just to try to have a seat at the table. Oftentimes society will not even allow them at the main table. They’ll put them to the kiddie table to the side, kind of patting them on the back, saying, “Hey we let you be here. You should be thankful.”

I often don’t know what to do with these feelings aside from talking with my therapist, my friends, and my family. I acknowledge the privilege that I have and the layers of privilege that exist in being a cis-het white man with a master’s degree who is also a small business owner. I don’t necessarily have to tell people that I’m disabled if I don’t want to. People don’t need to know that I’m Autistic, ADHD, Jewish, chronically in pain, or chronically ill. I can mask well enough where all of these things do not exist, or apparent to the outside looking in.

This does not mean that white Autistic people are not also marginalized and are not also disabled and vulnerable. It just means that there are layers of privilege here in terms of race and gender, socioeconomic status, et cetera.

This is just a reminder to amplify and support and advocate the more marginalized members of our community, the more vulnerable members of our community, because if we don’t have our more vulnerable members’ backs then this community is nothing without them. We need to have support for all people, not just people who look like me.

Autism is not a one size fits all nor is it a monolith. It’s certainly not one specific look or presentation and that’s the beauty of a spectrum. There is a lot of beauty in the diversity that exists, and we need to ensure that we are always including it.

I’d love to hear any actions you’d add to this list, too. Leave them in the comments so we can continue this work together.

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As always — Doubt Yourself, Do It Anyway

Until Next Time,

Patrick

Characters who get emotional for exactly one episode and then snap back to baseline. Leaders who have a Meaningful Moment and then return to performing competence like the whole thing never happened. Writers who understand that vulnerability is compelling on screen but stop short of showing what it actually does to a person, and to everyone around them.

And then there’s Ted Lasso and Shrinking.

Two Apple TV shows. Different premises, different tones, completely different worlds. And somehow they’ve both built the same argument, from completely different angles: that the most powerful thing a leader can do is refuse to pretend they’re okay when they’re not.

I’ve been thinking about this for a while. Not as a TV critic, but as someone who leads organizations, talks about this stuff publicly, and has spent a lot of my life performing competence I didn’t have while quietly falling apart underneath it.

Ted Lasso and the panic attack nobody was supposed to see.

Ted Lasso is a man who hides behind warmth. That’s the thing the show takes its time revealing. The biscuits, the jokes, the relentless positivity…it’s not fake, exactly, but it’s also armor. It’s a way of filling every room with so much light that nobody can see the darker corners.

And then Season 2 happens.

Ted has a panic attack in the middle of a match. In front of his staff. On the sideline. And the show doesn’t treat it as weakness, it treats it as a crack in the facade through which something real finally starts to breathe.

He eventually shares with the team’s sports psychologist, Dr. Sharon Fieldstone, his father’s suicide and his own personal panic attacks, and the help and advice he receives from her helps him deal with his own anxiety and become a better coach and person.

But here’s the part that matters for the leadership piece: when Ted shared the truth about his panic attack to his team of coaches, it provided a safe space for each of the others to “confess” their own imperfections to each other (aside from Nate).

The beauty of this show dismantling toxic masculinity, while highlighting vulnerability, connection, and how nobody gets through life alone is something I think about often.

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One person refusing to pretend to be strong when they can no longer keep up the facade, creates permission for everyone else to stop performing theirs. It’s not a speech. It’s just Ted, in the room, saying: I’m not okay. And because Ted said it, other people got to say it too.

When leaders are vulnerable, it gives the team permission to be vulnerable too.

I’ve watched that play out in my own work more times than I can count. The moment I stopped pretending I had things figured out (in a podcast episode, in a room full of clients, or in a newsletter) was the moment people started showing up differently. Not because I inspired them with my struggle. But because I made it safe to have one.

The thing Ted kept hiding — and why it mattered.

Ted Lasso is not a perfect example of vulnerability. The show is honest about that.

Ted lives vulnerability, although on some occasions he hides the things that hurt him the most, which results in him not being the best version of himself.

That tension is the actual story. Because this is what most of us do. We’re selectively vulnerable. We share the things that are safe to share. The stuff we’ve already processed, the lessons we’ve already extracted, the struggles that make us look introspective rather than broken.

And we bury the things that would actually cost us something to say.

Ted’s father died by suicide. That’s not a thing you drop into casual conversation. That’s the thing you carry for thirty years in the form of panic attacks and relentless positivity and an absolute refusal to sit in silence to be alone with your thoughts. The show understands that the performance of okayness is usually built on top of something specific that never got space to be said out loud.

Real vulnerability isn’t just being emotionally open in general. It’s telling the specific truth. And often times it’s sharing the real feeling in the moment. Not waiting until it’s passed.

When Roy hugs Jamie after he punches his emotionally abusive dad. When Rebecca does her power pose, confronting the patriarchy and simultaneously healing her inner child. When Colin comes out to the team. The list goes on and on…..

And in Shrinking, there’s Jimmy Laird. Who did it completely wrong. And that’s why he may be the better teacher.

Shrinking opens with a therapist who is drowning.

Jimmy Laird’s wife was killed by a drunk driver. His grief left him impulsive and erratic, often saying and doing things without much thought. His short fuse resulted in a reckless and destructive lifestyle when handling his emotions and his relationships. To cover up his grief, he turned to excessive drinking and recreational drug use, even at the detriment of his daughter and friends.

He’s supposed to be the one who holds the container. He’s the therapist. He’s a professional. He’s the person in the room who is trained to stay regulated so other people can fall apart safely.

And he cannot do it. Not even close.

What Jimmy does instead is start breaking every rule. He tells his patients exactly what he thinks. He moves a client into his guest house. He inserts himself into people’s lives in ways that are objectively inappropriate and sometimes genuinely harmful. His unconventional honesty creates dramatic ripple effects in the lives of his clients, friends, and colleagues.

Some of those ripple effects are good. Some of them are genuinely damaging.

And the show doesn’t let him off the hook for the damaging ones. That’s the difference between Shrinking and every other show that uses “radical authenticity” as a cover for someone just doing whatever they want and calling it growth.

Jimmy’s version of vulnerability, at least at the beginning, is not actually vulnerability. It’s exposure without accountability. It’s performing his pain so loudly that everyone has to deal with it whether they consented to or not.

That’s not leadership. That’s outsourcing your emotional processing to the people around you.

Paul Rhoades is the one who actually does it right.

Harrison Ford plays Paul Rhoades, Jimmy’s senior colleague and mentor. Parkinson’s diagnosis. Decades of being the person everyone else comes to. A lifetime of professional composure.

And the show builds him, slowly and carefully, into the most compelling portrait of what it actually looks like when someone in a position of authority decides to stop pretending.

Paul admits he doesn’t have everything figured out. He navigates his diagnosis in front of his colleagues. He lets Jimmy hold his hand. He cries. He makes mistakes and acknowledges them directly.

Ford delivers a masterclass in understated comedic timing and emotional vulnerability, proving he’s still got surprises up his sleeve.

What makes Paul land differently than Ted is that Paul’s vulnerability is never performed. Ted’s warmth has showmanship in it. He’s good at people, he knows it, and he uses it. Paul is not good at being open. It costs him something visible. You can see the effort. And that’s exactly why it’s so powerful when he does it anyway.

The people who lead with the most integrity are usually not the ones for whom vulnerability feels natural. They’re the ones who find it genuinely hard and do it anyway because they understand what it creates in the people around them.

What both shows understand that most leadership discourse gets wrong.

There’s a version of “vulnerability as leadership” that has been thoroughly corporatized.

You’ve seen it. The TED talk, the keynote, the carefully crafted narrative about the difficult thing I went through and what I learned from it. All delivered from behind a podium complete with a resolved ending.

That is not what Ted Lasso and Shrinking are doing.

What makes these moments so important is their placement. Ted is not a supporting character or an outsider, he is the lead of the show. When the lead is shown melting down in the middle of a football match, it’s not because of him being weak; it’s because of him being human.

And Jimmy Laird is not giving a keynote. He is collapsing in real time in front of the people who depend on him. Making mistakes, hurting people along the way, and attempting to repair things over and over again. Even when he gets it wrong, he keeps trying.

In Shrinking, we’re seeing the power of an incredible safety net. We’re seeing a grieving family receive the kind of long-term gentleness and support that gives them the best chance to heal.

That’s what real community looks like when real vulnerability is in the room. Not clean lessons. Messy, long-term, mutual support between imperfect people who show up for each other anyway.

Here’s what I take from both of them:

Vulnerability that makes you look good is not vulnerability. It’s content.

Vulnerability that costs you something…that risks the relationship, that admits the specific failure, that says the true thing while you don’t know the ending yet…that’s the thing that actually changes the people around you.

Ted learned this. Jimmy is still learning it.

And most leaders, most humans, most people who build things or run things or try to help people are somewhere in the middle of that arc. Selectively open. Performing okayness some of the time and doing it honestly at other times. Getting it wrong, trying to repair it, trying again.

The point is not to get to a point where vulnerability feels easy. The point is to do it anyway because you understand what it gives to the room when you do.

Both shows know this. And they’re better for it.

Let me know in the comments if you’ve watched either of these shows. I have more times than I can count and always love to talk about them.

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Doubt Yourself Do It Anyway,

Patrick

📎 A quick note before we get into it: Videos on AuDHD Journeys are now free for all subscribers. No more paywall. I want this content to reach the people who need it, and I don’t want a subscription tier to be the thing standing between you and feeling less alone. So welcome, all of you. I’m glad you’re here.

P.S. Thank you to our paid subscribers who have been supporting this space over the past few months. FYI, we’ve paused your subscriptions for now and are figuring out what the paid tiers are going to look like going forward. We will be transparent with you about the whole process.

Thanks for being here y’all.

There are two of me, and they want opposite things.

One of them wants the next thing. The next project, the next retreat, the next course, the next community, the next speaking gig, the next idea that lights up like a pinball machine. This is the part that built a business in 2016 I never expected to build, then a group practice, then the podcasts and courses and summits, one stacked on the next. This part is allergic to boredom. For this part, boredom isn’t neutral, it’s the trapdoor to a dark, fast depression, and it would rather burn than sit still.

The other one wants the dark on purpose. Stillness, sameness, a cottage in the Irish or New Zealand countryside with animals and nature and no emails and no “can we jump on a quick call.” This is the part that needs structure and routine and sensory safety, the part that feels like an exposed nerve ending getting shocked all day long. This part is tired in a way that sleep doesn’t touch. It wants to hibernate. It wants the world to get small and quiet.

In this video, I’m talking about what it’s like to live between those two. The AuDHD tug of war, as an entrepreneur and as a human. For years I let the first voice run everything, because chasing the next dopamine hit feels like flow, feels like creativity, feels like proof that I’m okay. I never once sat still long enough to feel proud of anything I made. And the second voice just kept getting louder, in the only language it has: I got sick more. I got more chronically fatigued than I’ve ever been. It started taking me longer and longer to recover from every launch, every conference, every yes.

I get honest about what happened when I tried to override the second voice anyway. I talk about the grief in finally listening and coming to terms with disability, with capacity, with limitation. And I say the part I don’t usually let out loud. I’m 39 and I feel like I’m a hundred. I look at the whole list of things I’ve made and I ask if it was worth it, and the honest answer is no.

So I’m not making a how-to video, because I don’t have the how. What I have is the work of trying to get both voices in the same room without one strangling the other. Trying to find the gray between all-or-nothing. Leaving the creative part somewhere real to live while not letting it sign future-me up for things he won’t have the body to do. Being cautiously optimistic about the reset I’m attempting, and realistic that it’ll help a little, not all at once, not like magic. I hope you’ll watch or listen to the full episode over on Substack, or bookmark it for your next walk or commute.

And if something in this one resonated for you, I’d love to hear about it. Whether you’ve got two voices pulling at you too, or you watched this and finally felt less alone in it, share below. That’s what this space is for.

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And if you know someone caught in their own tug of war, telling themselves to just push through, send this their way.

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As always…Doubt Yourself, Do It Anyway.

Until next time,

Patrick

As my chronic health conditions pile up and I learn about the things that I’m experiencing and how they impact me, I can’t help but think about my own mortality.

There’s something that I think I’ve always known since I was a child and I’ve said this jokingly more times than I can count, probably out of discomfort with the reality. I believe that I will die younger than I should. That even though I am turning 40 in August, midlife for me was 10 to 15 years ago, maybe even more.

Some of my recent diagnoses have made me acutely aware that the sands in the hourglass are quickly disappearing.

Unknowingly I have been writing like I’ve been running out of time since I was young. I have been creating like I’m running out of time since I was young. I’ve been in production mode like I’m running out of time since I was young.

Sure some of this is deeply intertwined with living in a capitalist hellscape that values productivity. Some of it is anchored into a core belief that my own self-worth is associated with my accomplishments but a lot of this was subconsciously because I have always been hyper aware of the fact that life is fleeting, life is short, and that time is running out.

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Time is one of the only resources that we don’t get back and it’s perhaps our most valuable resource of all. So many of us spend so little time thinking about the things that are actually important to us or the things that actually matter because we are so focused and engrossed in having to get through our day, working to live and survive.

I choose to spend my remaining time focused on what I can control:

• the things that I appreciate

• the experiences that I’ve had

• the connection opportunities that continue to exist in my life

and to really focus in on being more present with the people and places that I care deeply about.

I’m turning 40 and I think this is often an age and life transition experience that feels big, feels heavy, feels monumental. It’s almost as if, hey, I’ve made it halfway and all of a sudden I’m going to start having an existential crisis wondering who I am, what I’ve done, does my life have meaning in it?

For me I can answer very confidently yes to all of those things because I have had experiences over the last decade of my life, both personally and professionally, that a lot of people can only dream about. I am forever grateful for that and how my career has taken me all over the world.

Never in my life did I think that I had anything meaningful to say that people would actually listen to or that it would have impact on their day-to-day lives. I get DMs, emails, and messages thanking me for sharing my own life experiences, especially my struggles, helping to humanize and make more relatable experiences for people all over the world.

I certainly never thought that I would be traveling the world hosting retreats, conferences, and summits for mental health professionals in countries like New Zealand, Ireland, Scotland, Greece, Italy, Portugal, Spain, Belize, and more.

I have suffered and struggled my entire life and that has never been a secret. I think that people sometimes are drawn to me because they can see how much I’m struggling. I can’t hide it and the reality is I am more and more at peace with the fact that things are approaching a finality in a sense, in terms of lifespan, creative energy, physical limitations, etc. Not saying that tomorrow is it but recognizing that if I was to die tomorrow, would I have been proud of my life? The answer used to be no.

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I hope that me sharing so candidly and openly and vulnerably and letting you into the behind-the-scenes of my day-to-day helps you get through yours or at least helps you feel a little bit less alone. That’s always why I wanted to share my struggles because honestly I have felt so alone in this lifetime that I do not want another human to have to experience life the way that I do.

And let this be a reminder that when you share your experiences and get vulnerable, you truly never know who you might be helping.

As always — Doubt Yourself, Do It Anyway

Until Next Time,

Patrick

Throughout my life I have always been sick in situations, despite my best efforts and attempts to boost my immune system. While those around me constantly ask me questions, or make statements that feel really minimizing or demeaning, like “Patrick, you’re always sick” or “Oh my god, you’re sick again” or “You looked fine yesterday.”

Since slowing my life down because of the intense Autistic burnout that I created by not only just existing as an AuDHD human in this world but also as an entrepreneur who has pushed himself so far beyond his limits and his capacity that it’s left him unable to get off the couch most days, unable to function otherwise; I’ve realized that I’ve been suppressing, masking, or numbing my physical health symptoms and struggles.

Now that my nervous system has tried to regulate itself in a container that is a little bit more intentional and more slowly focused to support myself through burnout, it’s like this physical, chronic illness cluster has hit me like a fucking tidal wave.

The diagnoses have piled up over the years. Between having a rare throat condition that only impacts 0.001% of the population, which has already required two surgeries paralyzing my vocal cord permanently and forever changing my voice. I’ve also been dealing with chronic GI issues and urinary issues since I was a child. I have experienced physical pain that I can’t even often describe to medical professionals because it is so intense, so palpable, that I don’t know how to explain it because I don’t know how people don’t go through their lives experiencing the things that I do.

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As someone with hypermobility Ehlers-Danlos, I often can feel electrifying pain in the ligaments in my joints, in my tendons, even in my fucking blood vessels. I can feel my body not working properly alongside the dysautonomia that has been created. I can feel the mast cell activation syndrome overexerting itself, and sending out more cells to protect a body from a threat that is constantly perceived, that may or may not actually be there, constantly scanning for threat like the eye of Sauron looking for the one ring.

Then on top of this, heightened markers for certain types of cancer that have come back that are concerning, and mycotoxin poisoning that I’ve probably been dealing with for years of my life.

Brain fog, confusion, chronic pain, chronic exhaustion, severe heat intolerance. The list goes on and fucking on.

Over these last two weeks alone I have had the following doctor’s appointments on my schedule, making it feel like my full-time job is to go to specialist appointments and to be given different advice, to be put on new medications, supplements, testing, procedures, all to lead back to square one: a baffled doctor who throws up their hands, unsure of how to help.

These last two weeks have looked like:

• Me going to three physical therapy appointments to support my hEDS

• Two mental health therapy appointments

• Two urgent care visits for bizarre abnormal medical experiences that cannot be explained.

• Having an EKG of my heart done

• A cardiologist appointment

• An echocardiogram

• An ultrasound of my upper quadrant of my body

• An internal radiation appointment for pelvic venous insufficiency system

• An orthopedic appointment for a torn thumb ligament, which needed a cortisone shot directly into the joint

And now my primary care physician wants me to establish care with a functional medicine physician because she no longer feels like Western medicine has the answers. I agree. I don’t think Western medicine is designed to really truly support people with these interconnected complex illnesses that leave most medical professionals scratching their heads or asking you, “Have you tried mindfulness or meditation to reduce your stress and anxiety?”

All of this shit is fucking expensive. I am draining my savings on trying to stay healthy and alive and to try to figure out answers.

Those of us who experience chronic illnesses often have to also navigate:

• trying to hold down employment

• running a business

• having any semblance of a social life

• trying to stay present in a relationship

• other hobbies and activities outside of being our own patient advocates

• dealing with different medical appointments all over town

• spending energy trying to educate our providers because they don’t have the answers

• trying new supplements or medications and dealing with the side effects

It is a full-time fucking job that we are not getting paid for.

It’s exhausting and the interconnectedness of everything that I’m talking about often impacts Autistic and ADHD people in higher amounts than it does for neurotypical people. Yet our medical system, especially in the Western part of the world, is not designed to see a holistic picture. It’s fragmented and disjointed into specialists’ silos, with different amounts of co-pays, most of whom don’t even take health insurance and charge astronomical amounts of money out of pocket.

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It is a privilege to be able to afford all of this and still be able to survive but that doesn’t mean that it is any less demoralizing, exhausting, isolating, or overwhelming.

To those of you navigating complex chronic health conditions that the medical system often does not have answers to. My heart goes out to you. I know how much it fucking sucks. I know how much you want to give up and I just encourage you to keep fighting. You deserve to feel healthy; you deserve to feel seen and I know there are an enormous amount of obstacles and barriers in the way.

Until Next Time,

Patrick

📎 A quick note before we get into it: Videos on AuDHD Journeys are now free for all subscribers. No more paywall. I want this content to reach the people who need it, and I don’t want a subscription tier to be the thing standing between you and feeling less alone. So welcome, all of you. I’m glad you’re here.

P.S. Thank you to our paid subscribers who have been supporting this space over the past few months. FYI, we’ve paused your subscriptions for now until we figure out what the paid tiers are going to look like going forward and will be transparent with you about the whole process.

Thanks for being here y’all.

My wife Ariel and I recently celebrated 12 years of marriage. And for a lot of those years, I had no idea why I was struggling the way I was. Why I’d shut down at her family’s gatherings and she’d have to field questions about what was wrong with me. Why I’d be deep in focus and completely miss her trying to talk to me, and she’d feel dismissed. Why certain smells would wreck me for days and I couldn’t explain it without sounding like I was being dramatic.

Those were the pre-Autism discovery days and I didn’t have the language for what I was experiencing yet.

In this video, I’m talking about mixed neuro-type relationships. I’m sharing Ariel and I’s relationship as an example of what that can look like from the inside. I share what breaks down and what’s possible when two people are genuinely willing to learn each other.

I dive deep into the misdiagnosis years, meeting Ariel when I was still figuring out who I even was, getting my Autism diagnosis in 2021 and watching it crack everything open at once. The regression, the unmasking, the misdiagnoses…all of the dots for why things had been so difficult started to connect.

I also talk about what’s worked for us. The code words and accommodations that meant everything to me. Like when your partner starts putting the air fryer on the front porch so the smell doesn’t wreck your sleep. These small things are huge things.

This isn’t a how-to video by any means. It’s just one honest look at how we’ve navigated it. It’s amazing when someone can really truly see and listen to your needs and incorporate accommodations into your everyday life. I hope you’ll watch or listen to the full episode over on Substack or bookmark it for your next walk or commute.

And if something in this one resonated for you, I’d love to hear about it. Whether you’re in a mixed neuro-type relationship yourself, or you watched this and felt seen in a way you didn’t expect, share below. That’s what this space is for.

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And if you know someone who’s been trying to explain themselves to a partner and running out of words, send this video their way.

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As always…Doubt Yourself, Do It Anyway.

Until next time,

Patrick

Jokes on me because none of that is possible.

The reality is, when you are approaching Autistic burnout, it’s typically because things have compounded for a long period of time that have worn down your nervous system and your ability to cope with the demands and stressors of life.

When demands continue to pile up and the stressors exceed and overwhelm our ability to cope and manage, it leads to intense neurological depletion, and unbelievable chronic exhaustion. We cannot simply outthink or outrun or just change a couple of things in our lives and snap our fingers.

I think a lot of us assume incorrectly that once we work through burnout we will just go back to baseline but baseline is what got us here in the first place. In order to get out of burnout and prevent it from happening again, we cannot re-invent and re-create the wheel. We must break the wheel, as Daenerys Targaryen often says.

And that’s scary because in order to rearrange and reset our lives, we often need to take drastic measures because our nervous system is so stressed and we are experiencing such intense symptoms from the burnout experience.

That is when skill regression starts to happen or things that came naturally, easily, or without much effort, are now very, very challenging or almost impossible.

We also lose access to our special interest joy. We start to experience intensified sensory struggles in a heightened sensory awareness. Things that were maybe minimal or not that impactful suddenly become excruciatingly painful.

Maybe we start to pull away in friendships and isolate ourselves. Maybe we also start to experience mental health symptoms like depression, anxiety, OCD. Maybe our substance use goes up and hell maybe we actively become suicidal.

Wu-Tang said, “This ain’t nothing to fuck with,” and this is the reality. We cannot outthink something that is neurologically foundational. We have to change our environments completely and we have to completely restructure and reset our lives.

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I keep seeing and hearing other Autistic people say that they need a drastic reset. That they need to disappear from life and the demands that come with it. A lot of us often have this fantasy about disappearing into the woods or into the countryside. I’ve talked about it before that my fantasy is disappearing to an Irish countryside cottage surrounded by nothing but nature and animals.

And that’s how far gone we are. How we have been pushed so outside of our abilities to cope, and the stressors of life and the demands have piled up so intensely that it has depleted us and has impacted us in every way imaginable.

It’s almost foolish to think that you could outthink this, outrun this, or simply just go back to what you were doing after an extended period of time and not have the same results. We cannot go back to what got us here; it will just become worse. We will experience more physical struggles, more illnesses, more mental health conditions, more intensification of all of these things compound and dig a deeper hole that makes it almost impossible to get out of.

In order to exist in a world that is often too loud or too intense or too overwhelming, we need to completely rearrange the container. We need to rearrange what it means to structure our days and our weeks and how we spend our time. We need to be more intentional about where we focus our energy and the sensory input that we want to experience and the sensory input that we need to avoid at all costs.

We need to reduce as many demands as humanly possible, acknowledging that it’s impossible to reduce every demand, especially when we live in a capitalist hellscape that requires us to work to make money, otherwise ending up on disability, which ultimately may not be the worst possible outcome here.

We need to be really mindful of how we try to start incorporating meaning-making activities because we need those to feel like we have a purpose. We need to slowly reintroduce special interest joy, especially when it does not feel accessible at first. And we need to try really hard not to do everything at once.

And on the other hand, some of us really do need a drastic reset where we tear it down to the studs and rebuild. And because it’s gotten that bad, because it’s become that overwhelming, because it’s become that torturous.

Instead of trying to outrun the burnout, what I would encourage you all to do is take a step back, take a breath, and start to examine what got you here in the first place because this did not just happen overnight. This was likely a slow burn that intensified, bubbling beneath the surface, like the fires of Mount Doom.

Once we can identify the triggers and the things that put us on this trajectory, we can start figuring out how we can eliminate the things that we can control, the things that are creating and wreaking havoc on our nervous systems and our sensory systems.

And then slowly we can start to reintroduce the things that bring us joy, that help us have purpose, that feel like we can create connection, the things that are really important for us to feel human.

You can’t outrun this. You can’t outthink this. It’s coming for us all. But it does not have to end with digging such a deep hole that you cannot get out from under it.

Until next time,

Patrick

The joint pain was excruciating. Bones grinding. Joints popping in and out while I was lying completely still. I could feel the blood coursing through my veins, my arteries throbbing, a burning sensation radiating through my entire body.

I put my fingers on my wrist and felt the pulsating sensation of my pulse, trying to figure out if I was having a significantly more severe medical experience.

The simplest movement of changing my wrist or my ankle positioning sent shocks down my entire body.

It sounds unimaginable when you try to explain this to people. I can feel the dysfunction in my gut, my intestines, my stomach, in my arteries and my veins. I can sense when blood is pooling, when my body isn’t circulating the way it should. That heaviness felt fucking excruciating.

Then came the heart palpitations. Then the feeling I was about to faint. I grabbed my blood pressure cuff. 140 to 150 over 70 to 80. Heart rate of 120. For the next 20 minutes I sat there taking my blood pressure over and over, convinced I was having a heart attack or a stroke.

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The trigger?

I’d just spent two days visiting my dad in Florida. 95 degrees every single day. Add in air travel, the stress of a complicated medical appointment, and you have all the ingredients for a hypermobility EDS and dysautonomia flare. I can feel it reverberating through my entire body at a cellular level. Every organ. Every ligament. Every joint. All at once. While simultaneously knowing that my autonomic nervous system is not doing what it’s supposed to do.

Am I dying?

Then comes the mental spiral: am I dying or am I overreacting? A lifetime of medical gaslighting will do that to you. Being told your symptoms were anxiety, panic, trauma. You start to question your own body even when it’s actively failing you.

And as someone who already deals with chronic severe insomnia, of course I don’t sleep a single second after having this type of reaction and flare. Dooming me the next day to move through my world in a stage of brain fog and disorientation

My wife could tell something was wrong. She always can.

I’m 39 years old and I feel like I’m 90. I’ve felt this way my entire life. I just didn’t have language for it until recently. And here’s what nobody tells you about finally getting answers: awareness intensifies everything. Now I know what’s coming. I know the triggers. I know the names. I build in as many preventative measures as humanly possible. And I still can’t always stop it.

I’m not writing this for pity. I’m writing it because so many of us are living inside bodies like this, navigating hEDS, dysautonomia, MCAS, and more, mostly invisible, mostly dismissed, mostly alone in the flare at 2am wondering whether to go to the ER or try to just breathe through it.

Living like this is not only chronically exhausting, but it is constantly anxiety provoking and overwhelming. The propensity for unyielding stress is palpable.

You deserve to be believed. Your symptoms are real. And you are not alone in this.