Steroids are powerful medications prescribed for various medical conditions, reducing inflammation and suppressing the immune system. While effective, their influence extends beyond intended therapeutic effects, impacting numerous bodily systems, including the brain. This can affect mood and mental well-being, making it important to understand these broader effects.
Understanding Different Types of Steroids
Steroids fall into two main categories: corticosteroids and anabolic-androgenic steroids. Corticosteroids, such as prednisone, hydrocortisone, and dexamethasone, are commonly prescribed. They are primarily used to reduce inflammation and suppress immune responses, treating conditions like asthma, allergies, and autoimmune diseases. Corticosteroids are most frequently linked to mood-related side effects, including anxiety, when used medically.
Anabolic-androgenic steroids, often called “anabolic steroids,” are a separate class. These are synthetic derivatives of testosterone, used to promote muscle growth and enhance athletic performance, often without medical supervision. While their primary purpose differs from corticosteroids, anabolic steroids can also alter mood.
How Steroids Affect Mood and the Brain
Steroids, especially corticosteroids, can influence mood and lead to anxiety through several mechanisms within the brain. These medications interact with the brain’s neurochemical systems, including neurotransmitters like serotonin, dopamine, and gamma-aminobutyric acid (GABA). Corticosteroids can also disrupt the hypothalamic-pituitary-adrenal (HPA) axis, a central system for the body’s stress response. The HPA axis normally releases cortisol, a stress hormone, but exogenous steroids can interfere with this balance, potentially altering emotional regulation and cognition.
Steroids can directly affect specific brain regions involved in emotion regulation, such as the amygdala and hippocampus. The amygdala plays a role in fear processing, and corticosteroids can influence its activity. The hippocampus is involved in memory and stress responses. Prolonged or high levels of glucocorticoids, a type of corticosteroid, can lead to changes like dendritic atrophy in the hippocampus and prefrontal cortex, brain areas linked to depression and anxiety. The likelihood and severity of steroid-induced anxiety are influenced by several factors. These include the dosage of the steroid, the duration of its use, and an individual’s unique sensitivity to the medication. Pre-existing mental health conditions can also play a role, potentially increasing vulnerability to mood changes.
Recognizing and Managing Steroid-Related Anxiety
Individuals taking steroids should recognize symptoms of steroid-induced anxiety. These can include feelings of restlessness, nervousness, and irritability. Other symptoms include difficulty sleeping, racing thoughts, and in some instances, panic attacks, rapid heart rate, or muscle tension. While mild to moderate anxiety may occur in approximately 28% of people using corticosteroids like prednisone, severe psychiatric reactions are less common, estimated at about 5%.
It is important for anyone experiencing mood changes or anxiety symptoms while on steroids to communicate with their prescribing doctor. Patients should never abruptly stop or alter their medication dosage without professional medical advice, as this can lead to withdrawal symptoms or worsen underlying conditions. A healthcare provider might consider adjusting the dosage, exploring alternative medications, or implementing a gradual tapering schedule for the steroid if appropriate.
Beyond medical adjustments, various general anxiety management techniques can offer support. These include lifestyle changes and seeking professional help.
Regular physical activity, a balanced diet, and adequate sleep are beneficial.
Engaging in stress reduction practices such as mindfulness, deep breathing exercises, or yoga can help.
Seeking support from friends, family, or support groups can provide emotional comfort.
If anxiety is severe, persistent, or significantly impacts daily life, consulting a mental health professional like a therapist or psychiatrist is advisable.