If you’re on a treatment plan that includes steroids, it’s important to understand that while steroids are valuable tools in managing inflammation and immune-related conditions, they can mimic the stress hormones that activate our “fight or flight” response.
This can be particularly hard to manage alongside the stress of your diagnosis. Many patients report that steroids have a negative impact on their mood, sleep, and mental clarity. Dr Kurtis, a geriatric psychiatrist, shares insights into what patients on steroid therapy might experience, how to manage these effects, and the importance of staying connected with a healthcare provider.
Why steroids affect mental health and well-being
Steroids closely mimic our body's natural stress response by increasing cortisol-like activity, which can have noticeable impacts on the nervous system. The addition of these powerful medications may cause a range of mental and emotional responses.
According to Dr Kurtis, in a hospital setting, patients may experience heightened anxiety, irritability, confusion, or even delirium (severe confusion). For those already in a high-stress environment like an intensive care unit (ICU), these effects can be more pronounced.
Sleep disruptions, which are also a common side effect of steroids, can affect mental health. Other known steroid side effects include mood swings, behavioral changes and cognitive disturbances (where it can be hard to think, remember things, or make decisions).
How to cope with stress while on steroids
For patients who are hospitalized and experiencing increased stress from steroids, Dr Kurtis emphasizes that help is available. Psychiatric consultations can provide tailored support, including potential medications to ease the symptoms.
Outside of the hospital, though, managing steroid side effects often depends on personal lifestyle adjustments.
“Wellness practices make a significant difference, with exercise, hydration, good sleep hygiene, limiting alcohol, and attending medical checkups all being particularly important.”
Here are Dr. Kurtis’s key recommendations for maintaining well-being during steroid treatment:
Physical activity
Regular exercise can benefit both your mental and physical health. Steroid therapy may increase risks of osteoporosis, high blood pressure, and blood sugar fluctuations. Physical activities, especially weight-bearing exercises, help strengthen bones, manage blood pressure, and support cardiovascular health. Plus, exercise also helps regulate the body’s stress response, which can reduce feelings of irritability and the tendency to have mood swings.
Stay hydrated
Ensuring you drink plenty of water is important to help avoid the additional stress that becoming dehydrated puts on the body. Avoiding caffeinated and alcoholic drinks not only helps with maintaining your hydration levels, but they can also help you get a better night’s sleep.
Sleep hygiene
If you want to have the best chance of counteracting steroid-related sleep disturbances, you need to prioritize a sleep routine. Aim to go to sleep and wake up at roughly the same times every day. Think about setting the right mood for sleep, too. By creating a calming bedtime environment and practicing relaxation techniques, you can take active steps to ease your nervous system before bed.
Make or listen to music
There is increasing evidence that making or listening to music can help reduce stress by activating pathways in the nervous system that soothe us and promote emotional well-being. Other artistic activities like painting, knitting, or even simple coloring have similar effects.
Stay connected
Dealing with a medical condition and the side effects of treatment can feel isolating. Isolation is a common experience for patients, as they often find it difficult to share concerns about their condition or treatment with others. If you’re feeling alone or anxious, remember there are support and advocacy groups, both in-person and online, tailored to various medical conditions and treatments. Joining a group can provide comfort and connect you with others who understand your experience, offering both emotional support and practical tips for managing steroid side effects.
Talk to your doctor
If you experience irritability, sleep issues, confusion, or other behavioral changes, speak with your doctor. These symptoms can range from mild to severe, and it's important to monitor them closely and work with your healthcare provider to stay on top of things. You may find Sam’s mood and symptom tracker a helpful way to do this.
The bottom line
Steroid therapy can be life-changing, but managing side effects is crucial to maintaining your quality of life. Staying active, prioritizing sleep, and leaning on your support networks, can equip you to make life easier.
And remember, if you’re feeling uncertain about symptoms or side effects, never stop taking steroids abruptly. A sudden stop can lead to adrenal insufficiency, a condition where the body is unable to produce adequate levels of its own cortisol, resulting in fatigue, weakness, and low blood pressure. Working with your doctor on a gradual tapering plan is essential if a dosage change is needed, as this allows your adrenal glands to adapt.
Most importantly, work closely with your doctor to optimize your treatment and safely manage both your underlying condition and any side effects that arise.
Remember, always consult your doctor before making any changes to your medication or lifestyle to ensure the best care for your specific health needs.