A guide to weather the storm of steroid side effects

Steroid medications like prednisone or dexamethasone are often essential in treating inflammation or immune system conditions. But if you’ve noticed yourself feeling more anxious, on edge, or even uncharacteristically angry while taking them, you’re not alone. These emotional side effects are surprisingly common, especially at higher doses.

 

Here’s the good news: there are practical, safe, and evidence-based strategies you can use at home to regain a sense of emotional control. This guide walks you through some of the techniques recommended by mental health experts, including tools from cognitive behavioral therapy (CBT), mindfulness, journaling, healthy lifestyle habits, and guidance on when to speak with your doctor.

1.  Try CBT techniques to rebalance emotional reactions

Cognitive behavioral therapy (CBT) is widely used for anxiety and anger management. Even without a therapist, you can apply many CBT-based tools at home:

  • Catch it early: Notice early signs of tension (tight chest, racing thoughts, irritability). Simply pausing when you sense a surge of emotion gives you more control.
  • Use the STOPP tool, a quick five-step exercise: Stop, Take a breath, Observe what’s happening, Pull back to see the bigger picture, and Proceed with care.
  • Challenge unhelpful thoughts: Steroids can amplify worries or negative thoughts. When one pops up, write it down. Ask yourself: Is it 100% true? What would I say to a friend having this thought?
  • Use a Thought Record: This is a structured way to review your thoughts and replace them with more balanced alternatives.
  • Problem-solve one piece at a time: Feeling overwhelmed? Break the situation down and focus on one thing you can do to make a positive change. Small wins are the key.
  • Practice assertiveness: Speak up calmly and clearly about what you need. This helps prevent pent-up anger.
  • Move your body: Even a short walk can reduce physical tension and ease intense feelings.

2.  Use mindfulness and breathing techniques to calm the body

Mindfulness teaches you to stay grounded when your mind races. Breathing exercises in particular can quickly switch off the body’s stress response and help bring calm.

  • Box breathing: Inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and hold again for 4 seconds. Repeat several times.
  • Deep belly breathing: Breathe in slowly through your nose, letting your belly rise. Exhale through your mouth. Do this for a few minutes.
  • 5-4-3-2-1 grounding: Notice 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste. This shifts focus to the present moment.
  • Mindful movement: Gentle yoga or tai chi combines breath and body awareness to ease both physical and emotional tension.

Consistency matters. Even 5 to 10 minutes of practice daily can change how you respond to stress over time.


3. Journal your way through it

Writing helps you slow down racing thoughts and process what’s going on beneath the surface. There’s no one right way to journal, but here are some prompts to get started:

  • What triggered my anxiety or anger today?
  • What thoughts popped up? Are they facts or feelings?
  • What evidence supports or challenges those thoughts?
  • What part of this is in my control?
  • What small thing can I do next time this happens?

You can also use journaling to track patterns in your mood or reactions. Sam’s Journey Tracker helps you keep track of how you’re feeling, physically and emotionally, so you can share a complete picture with your doctor at each visit. 

4. Build healthy habits for stress control

Supporting your emotional health through lifestyle habits can make a big difference:

  • Stay active: Regular physical activity improves mood, helps manage stress, and supports bone and heart health, all of which can be impacted by steroids.
  • Hydrate well: Drink plenty of water and limit your intake of caffeine and alcohol. Both can increase anxiety or affect sleep quality.
  • Stick to a consistent sleep routine: Steroids can disrupt sleep, so try going to bed and waking up at the same time every day. Create a calm, screen-free wind-down routine.
  • Explore creative outlets: Engaging in music, painting, crafts, or puzzles can activate your relaxation response and offer a healthy emotional release.

These simple habits work best when practiced consistently, even in small doses.


5. Know when it’s time to ask for help

While many people can manage mood side effects on their own, it is important to recognize when professional support is needed:

  • If anxiety, rage, or panic is making daily life difficult.
  • If you’re having thoughts of harming yourself or others.
  • If you experience confusion, paranoia, or feel detached from reality.

These could be signs of a more serious reaction. Speak to your doctor as they may adjust your dose, split your medication differently, or add a short-term medication to stabilize your mood. Never stop steroids suddenly without medical advice.

 

Using Sam’s Journey Tracker helps you keep a log of your symptoms, mood, or side effects to bring to your appointments. This gives your doctor a clearer picture and can support more effective medication planning.

 

Don’t panic

Steroid-induced anxiety and anger can feel intense. These are real and recognized side effects, and you are not alone. 

 

With a bit of support, structure, and self-compassion, it is absolutely possible to feel more in control while continuing the treatment your body needs.

 

For more compassionate guidance on managing steroid side effects and supporting your emotional well-being, click here.