JMIR Publications

ABSTRACT

Generative Artificial Intelligence (AI) tools are increasingly integrated into daily life, offering cognitive support across domains such as writing, decision-making, and social interpretation. While beneficial, excessive reliance may contribute to diminished confidence in one’s own thinking. This report describes a woman in her mid-20s with Generalized Anxiety Disorder and Major Depressive Disorder who developed a pattern of functional dependence on generative AI tools- specifically ChatGPT. She historically had strong social, academic and occupational functioning. Psychiatric consultation did not suggest the presence of a personality disorder, and although she was a high-achieving individual, clinically significant perfectionistic traits were not evident. Despite this, she increasingly relied on AI for routine cognitive and interpersonal tasks including composing emails, interpreting social interactions, predicting the future and making decisions and felt increasingly uncomfortable completing such tasks independently. This case highlights the potential danger of generative AI tools in reassurance seeking behavior and how it might compound anxiety. These behaviors were observed across both professional and personal contexts, suggesting that AI use was not limited to task-specific assistance but reflected a generalized strategy for managing uncertainty and self-doubt. This behavioral pattern is characterized in this case by cognitive offloading, reduced confidence in independent judgment, and reinforcement of externalized thinking processes. This led to the subjective belief of declining skill and compromised functional autonomy. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model was used to describe this pattern of behavior. While repeatedly turning to a family member or friend for validation and reassurance might lead to interpersonal fatigue, AI tools have no such limits and are infinitely accessible. This might ultimately worsen a patient’s ability to tolerate uncertainty. Given the ubiquity of AI tools and the prevalence of anxiety disorders, clinicians may need to be aware of the role AI tools potentially play in reassurance seeking and thus perpetuation of anxiety.