Steroids, such as prednisone or prednisolone, can be lifesaving for many conditions, but they may also lead to emotional side effects such as depression and anxiety. If you’re experiencing these feelings while on steroids, you are not alone.
How to recognize depression and anxiety
Depression and anxiety often come hand in hand. For example, when someone feels anxious, it’s common for symptoms of depression to follow, and vice versa. The balance between these symptoms varies from person to person - some may experience more depressive symptoms, while others feel a stronger sense of anxiety.
Depression might present as:
- Feeling down or hopeless
- Low energy levels
- Lack of interest in activities you usually enjoy
- Changes in sleep patterns - either too much or too little
- Poor appetite or overeating
- General withdrawal or not wanting to engage with others
In the context of steroid use, the most frequently reported depressive symptoms are low mood, decreased motivation and fatigue (low energy). If you already have a history of depression, these symptoms may worsen, making it feel like you’ve fallen far below your usual baseline.
On the other hand, anxiety can feel more like:
- Restlessness or being “on edge”
- A strong sense of doom or worry that something is about to go wrong
- Feeling overwhelmed or like everything is "too much"
- Physical symptoms such as a racing heart, shortness of breath or even full-blown panic attacks
Patients who have never experienced anxiety before can find these new feelings distressing. Patients with a history of anxiety may find that steroids make their symptoms worse.
Why does this happen?
Steroids are powerful anti-inflammatory drugs that can impact the balance of chemicals in your brain and cause emotional side effects like anxiety and depression. These effects tend to be more intense with higher doses or longer courses of steroid treatment.
How are these symptoms managed?
If you’ve never had depression or anxiety before, these emotional changes may resolve on their own once your steroid course is completed or your dosage is reduced. However, in some cases, a short-term course of antidepressants may be recommended to help manage these side effects while you are on steroids.
For those who already have a history of depression or anxiety, having your doctor adjust your existing medications may be necessary. Steroids may heighten your symptoms to a degree that simply tapering off (slowly reducing) your steroids won’t bring you back to your usual mental health baseline. If that’s the case for you, your doctor may recommend temporarily increasing the dose of your antidepressant or anti-anxiety medication.
When to seek help
If you’re noticing significant changes in your mood or anxiety levels while on steroids, it’s important to talk to your doctor. Even if you think it’s just the medication, these symptoms can interfere with your well-being and daily life, so seeking support is always the right choice.
The bottom line
Depression and anxiety are common side effects of steroid use, but they are usually manageable, and you definitely aren't alone as you face them. Whether through adjustments to your steroid dose or temporary changes to your mental health medications, there are ways your doctor can help you feel more like yourself again.
Remember, always consult your doctor before making any changes to your medication or lifestyle to ensure the best care for your specific health needs.
Have you logged your mood today?
The Sam Journey tracker can be a useful aid to open communication, allowing your doctor to help you navigate these difficult side effects safely and effectively.