Case report: woman in her mid-20s with anxiety came to rely on ChatGPT for reassurance and decisions, reported lost confidence in her judgment (JMIR Form Res)

Sarah Armstrong (Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University), 'Problematic Reliance on Generative AI in an Anxious Young Adult: Case Report', JMIR Formative Research 2026 (doi 10.2196/98297), published online 16 September 2026 with the patient's written consent and a changed first name. The patient, a woman in her mid-20s with generalised anxiety disorder and major depressive disorder whose symptoms were relatively well managed, had never required psychiatric hospitalisation and had strong social, academic and occupational functioning. She was introduced to ChatGPT at work in summer 2024, when her boss recommended it for customer emails, and over the following two years increasingly turned to it when uncertain, sometimes several times a day: she reported using it for about 90% of professional emails, asked it for reassurance about how messages would be perceived, uploaded messages from romantic partners and asked what they meant or how to reply, asked it to predict graduate-school admissions and whether she and an ex-boyfriend would get back together, and used it for large and small decisions. The author writes that she came to view ChatGPT as an authority, became distressed by her own use, described decreased confidence in her judgment and skills, used it compulsively even when asking for predictions increased her distress, and used it as an alternative to talking with friends, family or a therapist. She said that she now stared at the screen and could not write a sentence, and concluded on reflection that the problem was confidence more than competence. She raised the concern unprompted in therapy. The author interprets the pattern with the I-PACE model and writes that ChatGPT's constant availability and agreeableness likely reinforced her reassurance seeking and underlying anxiety; the report notes the absence of significant functional impairment and her existing anxiety and low self-worth, states that it cannot confirm a causal relationship between generative AI use and changes in confidence, cognition or functioning, and says that actual and perceived decline could not be distinguished and that her perceived skill deficit was likely at least exaggerated.

The case report's author reports that the patient became distressed by her compulsive ChatGPT use and described decreased confidence in her own judgment and writing; the author attributes this to reassurance seeking that ChatGPT's availability and agreeableness likely reinforced, notes no significant functional impairment and writes that the report cannot confirm a causal relationship.

Published as a case report (JMIR Form Res 2026, doi 10.2196/98297, PMID 42748377, PMCID PMC13581145). The report describes the pattern and the author's interpretation; it gives no treatment outcome for the AI use.