Anxiety Addiction and Crisis-Dependent Function

How we hold ourselves back by needing anxiety to function.

Grant H Brenner MD DFAPA
4 min readNov 27, 2023
Photo Credit: Grant H Brenner

At a cardiac arrest, the first procedure is to take your own pulse.

- Samuel Shem, MD, House of God

What is “anxiety-dependent functioning”?

For many years now, I’ve been thinking about the idea of “anxiety-dependent functioning” and using the concept in clinical and organizational settings. People get it right away. People also like the term “crisis dependent functioning”, for contexts in which the stakes are experienced as higher, and seems there is with impending disaster.

It’s a simple yet powerful notion: people develop the need to get highly activated in order to perform basic functions, and that sustained activation while adaptive at first leads to impairment. Sustained stress has been clearly shown to impair cognition and lead to changes in brain structure and function (Shalev, Gilboa & Rasmusson, 2011). Crisis mode is short-term solution which unconsciously becomes deployed as a routine, long-term solution. Anxiety dependence becomes a self-sustaining dysfunctional system, similar to an addiction. Somehow diminishing returns and bad outcomes aren’t enough to get us to change our ways, at least not until something really terrible happens. It leads to…



Grant H Brenner MD DFAPA

Psychiatrist, Psychoanalyst, Entrepreneur, Writer, Speaker, Disaster Responder, Advocate, Photographer