#119 - Masking, Missed Diagnoses, ADHD in Relationships and Tools that Work with Dr. Bryan Gastelle

On this episode of the State of Mind Mental Health Podcast, I sit down with Dr. Bryan Gastelle, a clinical psychologist and the founder of Empower Psychotherapy, a fully remote practice serving clients across multiple states. Bryan works primarily with neurodivergence — ADHD and autism — along with couples, trauma, anxiety, and depression. We get into the stuff that usually gets skipped. Why autism flies under the radar for decades, and how masking actually forms. Whether people on the spectrum really lack empathy (the answer is more interesting than you'd think). What sensory overload feels like, and the small adjustments that take the edge off. Where ADHD and autism overlap around executive function, and what AuDHD means. Why ADHD gets missed in girls so often. And whether the rise in diagnoses is a real increase or just better recognition. Then we go practical. Exercise and the neurotransmitter cocktail it releases. Meditation as attention training — treating focus like a muscle that starts out weak. The do-it-now rule for short tasks. Building SMART goals so a vague plan stops feeling impossible. And how ADHD shows up in relationships through forgotten texts and undone dishes, plus how both partners can meet in the middle without it becoming an excuse. We close on shame — the self-blame that piles up after years of being told you're lazy — and how Bryan dismantles that in CBT. Live with courage, clarity, and compassion. Practice inner strength, and develop within. Chapters: [00:00:00] Cold Open: When ADHD Looks Like "You Don't Care" [00:01:04] Welcome and Meet Dr. Bryan Gastelle [00:05:11] Obvious Cases vs. Flying Under the Radar: How Autism Gets Missed [00:09:50] Do People on the Spectrum Lack Empathy? And How Therapy Actually Helps [00:14:31] Sensory Overload: Eye Contact, Crowds, and What Takes the Edge Off [00:19:12] AuDHD, Executive Function, and Why Diagnoses Are Rising [00:23:21] Why ADHD Looks Different in Boys and Girls [00:27:44] Exercise, Meditation, and Training Attention Like a Muscle [00:32:00] ADHD in Relationships: Texting, Chores, and Real Compromise [00:36:05] Do It Now: SMART Goals and Offloading Working Memory [00:40:12] Shame, Self-Blame, and Why It's Not a Character Flaw [00:44:31] Final Advice and Where to Find Bryan Learn more about Bryan's work: https://www.empowermytherapy.com/ Free 1-month of the Meditation App - Waking Up https://dynamic.wakingup.com/guestpass/SC58BD912 Please Subscribe to my YouTube - YouTube Subscription Link Disclaimer Professional medical care and psychotherapeutic services are not offered on this Youtube channel. It is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such condition. Seeking professional support is encouraged if you think you have an issue and that you want help.