Steroids are medications often prescribed for various medical conditions, but their influence can extend beyond physical effects to impact an individual’s mood. Their interaction with the body’s systems can alter emotional states, making mood changes a common concern. Understanding these potential effects is important for patients, caregivers, and healthcare providers to navigate treatment effectively. This influence varies depending on the type of steroid, dosage, and individual factors, highlighting the need to distinguish between steroid categories.
Understanding Different Steroids
Steroids are categorized into two main types: corticosteroids and anabolic-androgenic steroids (AAS). Corticosteroids, such as prednisone and dexamethasone, are synthetic versions of cortisol, a hormone naturally produced by the adrenal glands. These medications are used to reduce inflammation and suppress the immune system, treating conditions like asthma, allergies, autoimmune diseases (e.g., lupus, rheumatoid arthritis), and inflammatory bowel disease. They can be administered orally, topically, via injection, or through inhalers, as needed.
Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone, the male sex hormone. Anabolic refers to tissue building (muscle growth), and androgenic to developing male characteristics. Medically, AAS are prescribed to treat conditions such as male hypogonadism (low testosterone), delayed puberty, certain types of breast cancer, and muscle wasting in chronic illnesses like AIDS or some cancers. However, AAS are also frequently misused for performance enhancement and body image improvement, often at doses higher than prescribed.
How Steroids Interact with Mood
Both corticosteroids and anabolic steroids can influence mood through physiological pathways. Corticosteroids, which mimic the body’s natural cortisol, affect the central nervous system. They can alter brain structure, impacting white and gray matter, and influence neurotransmitter systems like serotonin and dopamine, which are involved in mood regulation. The hypothalamic-pituitary-adrenal (HPA) axis, a system that regulates stress response, is also affected by corticosteroids, leading to mood changes.
Anabolic-androgenic steroids exert their effects through hormonal pathways. They activate androgen receptors throughout the body, mimicking the actions of testosterone. These hormonal shifts can impact brain chemistry, influencing areas associated with mood, reward, and aggression. Rapid fluctuations in hormone levels, especially when AAS are used at high doses or cycled, can destabilize brain function and contribute to mood alterations.
Recognizing Mood Changes
Steroid use can lead to mood and behavioral changes, varying by individual, steroid type, and dosage. For corticosteroids, both “up” effects (increased energy, euphoria, irritability, or manic symptoms) and “down” effects (depression, anxiety, or low mood) are possible. Cognitive difficulties, such as memory problems or confusion, have also been reported. These psychiatric symptoms are often dose-dependent, as higher doses increase risk and severity.
Anabolic-androgenic steroids are associated with increased irritability, aggression, and mood swings. The term “roid rage” describes outbursts of anger and hostility that some individuals experience. Users may report feelings of heightened energy and power, but these can quickly shift to states of depression, anxiety, or even paranoia. Mood disturbances with AAS can be pronounced, with studies showing a percentage of users reporting major mood syndromes, including mania, hypomania, and depression.
Addressing Mood Alterations
If mood changes occur during steroid therapy, open communication with a healthcare provider is important. Patients should not attempt to adjust steroid dosages on their own, as this can lead to adverse effects, including withdrawal symptoms. Medical supervision is necessary to safely manage steroid tapering or dosage adjustments, which can alleviate mood-related side effects.
For persistent mood alterations, seeking professional medical advice is important. Healthcare providers can evaluate the situation and recommend strategies, which might include medication to manage specific symptoms like depression or anxiety. Psychological support, such as therapy or counseling, can provide coping mechanisms and support for individuals experiencing emotional distress. Informing family and friends about potential mood changes can foster understanding and support during treatment.