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Updated June 24, 2025 Reviewed by Abigail Fagan
I’ve been thinking again a lot lately about what I call “crisis-dependent functioning”1—a pattern I consistently witness in my practice, and among colleagues (and perhaps even personally sometimes) where people literally need high levels of activation and stress to get things done.
Here’s what appears to be happening: people become inured to heightened arousal states to initiate and sustain day-to-day activities. Sure, this activation might work in the short term—our brains are wired for possible crisis response, after all, and we tend to give more weight to threat detection with our “caveman’s brain” (Szent-Györgyi, 1970). But when you’re constantly running on stress, cognition gets impaired and the brain literally starts changing structure. The research on sustained stress and brain function is clear about this (Shalev, Gilboa & Rasmusson, 2011).
Moreover, people with clinically significant problems in adulthood stemming from childhood adversity reflect this as well, with notably different patterns of connectivity among key brain areas compared with those without childhood maltreatment (Gerin et al., 2023). Crisis-dependent functioning often starts early in life, leading people to have difficulty with emotions and relationships, but are able to get things done out of a sense of survival and drive, often only living a part of who they fully are, or could be. There is often a sense of something missing. Research overwhelming supports the finding that early trauma is related to negative adult outcomes for mental and physical health and relationships, though some individuals are more resilient, and may benefit from post traumatic growth to transcend and excel.
The whole pattern is fundamentally about avoiding genuine self-recognition and engagement by relying instead on neglect and denial as motivational tools. In our “Irrelationship” work2, my colleagues and I trace a lot of this back to early developmental experiences where kids learn that chaos equals productivity. Anxiety is much more about social learning than pure genetics (Eley et al., 2015). Kids internalize family behaviors, emotional patterns, problem-solving styles, communication patterns—all of it becomes their template. Kids see parents responding with frenzied activity to avert disasters, which temporarily “saves the day” but reinforces the whole pattern. The reactive approach leaves other responsibilities unaddressed due to exhaustion and preoccupation, which sets up the next crisis.
When you’re dependent on anxiety for basic functioning, your ability to accurately read situations becomes severely compromised. You end up in this cascade where you’re frantically putting out fires, but your hasty attempts just scatter sparks that create new fires. It becomes this self-reinforcing cycle of dysfunction.
What gets damaged? Pretty much everything important. Your perception becomes distorted—you can’t accurately read yourself, other people, or situations. You make decisions based on incomplete, often wrong information. You lose the capacity to learn from experience because sustained anxiety messes with self-appraisal and course correction. You keep reinforcing the same misconceptions about yourself and how problem-solving works.
Most critically, your executive functioning—reflection, planning, assessment, strategic action—gets derailed. Emotions get sidelined, alexithymia sets in. Without these cognitive processes working properly, effective functioning becomes nearly impossible.
In high-stress environments or with chronic pressure, these dynamics become even more pronounced and entrenched. Every single problem gets approached as if disaster is imminent, regardless of what’s actually at stake. Real-time reflection and situational processing become impossible. Without extensive preparation and practice, your automatic responses can lead you into genuinely dangerous territory.
Self-care inevitably suffers because all your resources are depleted, which creates this compound effect where you have even less capacity to slow down and think clearly.
There’s a related pattern I see regularly—”exhaustion-dependent functioning.” This is where people require extreme fatigue or complete depletion before they’ll give themselves permission to rest, seek help, or acknowledge any limitations whatsoever. It’s another form of completely dysregulated self-management that often develops right alongside chronic anxiety-dependent patterns.
In this version, people unconsciously use physical and emotional depletion as the only acceptable reason to step back from demands. They’ll work relentlessly until they hit a breaking point, then finally allow themselves limited recovery time. They don’t usually fully refuel, reflecting these deeply ingrained beliefs about worthiness, productivity, and whether rest is ever actually acceptable.
The cycle is predictable: intense overwork and self-neglect, followed by crashes that force temporary rest, followed by guilt and renewed overwork to “make up for” the downtime. It’s the same boom-bust cycle that prevents any kind of sustainable performance or well-being, and serves to continue to keep folks estranged from themselves. And being estranged from oneself does a number on intimate relationships, friendships and parenting.
People caught in this describe feeling unable to rest unless they’ve “earned it” through complete depletion. They unconsciously push themselves to exhaustion as a way to get permission—from themselves or others—to finally stop. They ignore people who try to help them, or get annoyed or even rageful. They don’t sleep, they crash. They don’t take breaks, they’re forced to stop. I see this particularly with high achievers and compulsive caregivers3, and it runs with perfectionistic tendencies.
Everyone’s path to anxiety-dependent functioning looks different, but the endpoint is remarkably similar. Without intervention, these developmental and family patterns get reinforced through adolescence and adulthood, gradually consolidating over time. At this point, it may seem like it is simply personality, written in stone.
The longer you rely on anxiety-dependent approaches, the more entrenched this becomes neurologically. The brain pathways associated with stress-driven performance get stronger while those supporting calm, reflective problem-solving weaken from disuse.
Recognition—”discovery” in the irrelationship DREAM Sequence of Discovery, Repair, Empowerment, Alternatives and Mutuality—represents the crucial first step toward change. Once individuals can identify these patterns in their own functioning, they can begin to create space for breathing room and reflection. Breaking free from anxiety-dependent and exhaustion-dependent functioning requires:
The encouraging reality is that these effective alternatives do exist, and that human beings have a tendency to right ourselves, often driven by what psychoanalyst Wilfred Bion (1962) called the “psychoanalytic function of the personality”. With proper recognition, space for recovery, and commitment to change, these maladaptive patterns can be unlearned. AI represents a cross-roads here, holding promise to relieve the burden of drugery, but a great risk of putting more pressure on humans to stay afloat, and even up performance expectations. The key is creating enough psychological safety and support to risk abandoning familiar, albeit dysfunctional, coping mechanisms for more adaptive strategies.
References
1. Some prefer the softer term “anxiety-dependent functioning” because it captures that constant sense of impending disaster that keeps the whole dysfunctional machine running. I’ve seen it most clearly when I was a surgical resident, working 100 or more hours per week, in disaster response, and among first responders and high performing people in corporate settings. It takes a toll on families, friendships and oneself, though it can be very hard to see alternative ways to go about things, as it often just seems like “reality”. When I describe this to patients and colleagues, it usually clicks.
2. Irrelationship Book Series
Irrelationship: How We Use Dysfunctional Relationships to Hide from Intimacy
Relationship Sanity: Creating and Maintaining Healthy Relationships
Making Your Crazy Work For You: From Trauma and Isolation to Self-Acceptance and Love
3. A Review of Anna Freud’s Concept of “Altruistic Surrender”
4. The Hebbian Doctrine
Citations
Bion, W. R. (1962). Learning from Experience. London: Heinemann.
Eley TC, McAdams TA, Rijsdijk FV, Lichenstein P, Narusyte J, Reiss D, Spotts E, Ganiban JM, Neiderhiser JM. 2015. The intergenerational transmission of anxiety: a children-of-twins-study. The American Journal of Psychiatry, Vol 127, Issue 7, July 01, pp. 630-637.
Gerin, M. I., Viding, E., Herringa, R. J., Russell, J. D., & McCrory, E. J. (2023). A systematic review of childhood maltreatment and resting state functional connectivity. Developmental Cognitive Neuroscience, 64, Article 101322. https://doi.org/10.1016/j.dcn.2023.101322
Shalev A, Gilboa A, Rasmusson AM. 2011. Neurobiology of PTSD in Post-Traumatic Stress Disorder, in Post-Traumatic Stress Disorder (eds. Stein DJ, Friedman MJ, and Blanco C). John Wiley & Sons, Ltd, Chichester, UK.
Szent-Györgyi, A. (1970). The crazy ape. Philosophical Library.
Full quote: “We are forced to face this situation with our caveman’s brain, a brain that has not changed much since it was formed. We face it with our outdated thinking, institutions and methods, with political leaders who have their roots in the old, prescientific world and think the only way to solve these formidable problems is by trickery and double talk, by increasing our atomic arsenal…”
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Grant Hilary Brenner, M.D., a psychiatrist and psychoanalyst, helps adults with mood and anxiety conditions, and works on many levels to help unleash their full capacities and live and love well.
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The brightest way to shine is by being fully, imperfectly yourself.
Self Tests are all about you. Are you outgoing or introverted? Are you a narcissist? Does perfectionism hold you back? Find out the answers to these questions and more with Psychology Today.
