Is ‘Roid Rage Real? 7 Myths Debunked
Are mood and personality changes real for those taking prednisone? Are they merely figments of our imagination? Is “‘roid rage” real? Continue reading to find out!
Prednisone causes 150 known side effects, one of which is commonly known as “‘roid rage.” ‘Roid rage causes personality changes, and it may affect your relationship with your family, friends, and co-workers. Once you begin experiencing these side effects, you should inform those closest to you that you are taking prednisone and that this is one of the unfortunate side effects.
What is Roid Rage?
I posted the meme seen below on my Facebook and Instagram pages showing Medusa the Gorgon with her snake head screaming, “Beware! I’m on prednisone!” I posted it out of humor, saying that prednisone is even worse than the rage Medusa must feel for being banished and cursed with the ‘death glare’ and evil snake head.
Not too long after posting this, I was met with the following response from an online commenter (troll):
“Roid Rage is a term used to describe what happens to bodybuilders when they take anabolic steroids. Anabolic steroids raise testosterone, causing intense anger. Glucocorticoid steroids do not have that effect. When HC or Prednisone doses are too high, a person tends to eat too much, and have feelings of sadness and depression. Anyone experiencing rage while taking glucocorticoid steroids has another hormone imbalance and should be tested for testosterone levels. Your meme is misleading people who don’t understand steroids and making it harder for patients to navigate the world.”
In short, this person stated that ‘roid rage, caused by prednisone, is a myth. In addition to this, this person believes that that ‘roid rage is caused by one eating too much.
Please understand that this simply is not true. There is scientific research to prove that ‘roid rage is not caused by your diet. This is an extremely misinformed and dangerous statement to make towards prednisone warriors who are struggling with both their mood and appetite, who often feel that the changes their bodies and minds are going through are their fault.
I am here to discuss and debunk the myths surrounding prednisone. I don’t want anyone taking prednisone or any other steroids and feel like this and be dismissed and told that it’s because you’re eating too much. Check out the video below, and continue reading to see seven myths, about prednisone, get debunked.
7 Myths about Prednisone Debunked – ‘Roid Rage is Real!
Buckle up, because we are about to debunk some common misconceptions with facts!
Let’s start by dissecting the statement the commenter made on my meme.
“‘Roid rage is a term used to describe what happens to bodybuilders when they take anabolic steroids”
I will start by saying that this is a factual statement!
Anabolic steroids do raise testosterone causing intense anger. The type of steroids that the commenter was talking about are anabolic steroids, which is what bodybuilders and/or people who abuse steroids use so they can excel in sports or achieve a certain aesthetic.
The commenter also states that “glucocorticoids do not have that effect.” Not true!
“When hydrocortisone or prednisone doses are too high, a person tends to eat too much and have feelings of sadness and depression. In other words, overeating, sadness, and depression are a result of high prednisone levels. Anyone experiencing rage while taking glucocorticoid steroids has another hormone imbalance and should be tested for testosterone levels.”
“Your meme is misleading people who don’t understand steroids and making it harder for patients to navigate the world.”
So false! They started with a little bit of truth (anabolic steroids are not prednisone). Prednisone is a glucocorticoid and makes muscles atrophy. Anabolic steroids are male hormones that boost muscles.
I responded to this commenter with the following statement,
“I agree that the term ‘roid rage is confusing. I’m sorry if it seems that it is making it harder for patients to navigate the world. However, please understand that my intention is not to misinform. Rather, it is to make the time suffering while on steroids as pleasant as possible. One of the ways I’ve found to make life, on prednisone, a bit more pleasant is through humor memes such as this one. I found it online to help us accept our condition and situation. It helps us to realize that we aren’t alone in our suffering.
Do steroids cause anger?
I must respectfully disagree that corticosteroids, like prednisone, and other glucocorticoids don’t cause rage. There is a multitude of scientific literature documenting the dramatic, and sometimes terrible, mood changes from prednisone.
I also receive phone calls, at least once a week, from people who had no previous mental illness and who have never suffered from excessive hunger. These patients are new to taking prednisone and are having debilitating and miserable side effects, such as ‘roid rage.
To answer this question: Yes, even steroids, such as prednisone, can cause anger.
Fact #1: Mania
The most common mood change from prednisone is mania.
While mania is attributed to anabolic steroids, it happens with prednisone, as well. People who deal with manic episodes may feel lost and not know what to do to cope with these new psychiatric changes. While this is frustrating, there are ways in which you can better deal with this ‘roid rage.
Depression is another highly reported side effect. Although depression is a commonly reported side effect (typically after one has been taking prednisone for a while), manic disorders are one of the most common mood changes that prednisone warriors go through.
Fact #2: Side Effects are Similar to Bipolar Disorder
The second truth that we find out in here this fact is that “Both the symptoms and the treatment response of the psychiatric mood changes while on prednisone and other steroids are similar to those of bipolar disorder.” Do you know what bipolar disorder is?
According to psychiatry.org, bipolar is a brain disorder that’s responsible for mood changes, energy, and a person’s functional ability. People who suffer from bipolar experience intense mood and emotional changes. They have extremely high “highs” and extremely low “lows.”
This is very similar to mania and the “highs” are similar to ‘roid rage.
Fact #3: Mood Changes are Reversible
Mood changes are reversible when stopped. Research specifically states, “corticosteroid-induced mood and cognitive alterations have been shown to be reversible with dose reduction or discontinuation of treatment.” What does this mean? Simple. It means that your mood changes are not your fault and that with reducing the dosage or discontinuation of treatment (by slowly tapering off, as you should never quit prednisone cold turkey), corticosteroid-induced mood and cognitive alterations have been shown to be reversible. When you stop taking prednisone, the side effects go away. It has nothing to do with your appetite!
Fact #4: High Levels of Cortisol are Related to Psychiatric Symptoms
Research shows that high levels of cortisol may be a cause of psychiatric conditions. Some people have psychiatric illnesses because their body is naturally making too much cortisol.
It’s as if some people suffering mental illnesses were taking a pill like prednisone–but instead, it’s their own body secreting too much cortisol.
The high cortisol level alone is correlated with psychiatric symptoms.
Is it because they are having so much stress from the psychiatric illness that their body responds with high levels of cortisol? Or is it that a complication of psychiatric illness causes high levels of cortisol? Chicken or the egg?
Fact #4 again proves that the ‘roid rage has nothing to do with appetite.
Fact #5: Mood Changes are Very Common
According to Thomas P. Warrington, MD and J. Michael Bostwick, MD at the Mayo Clinic, mood changes from prednisone are far more common than what people realize. They can range from mild to severe. Some of the most frequently reported symptoms include:
- psychotic or mixed affective states
- cognitive deficits
- minor psychiatric disturbances (looks like ‘Roid Rage!)
- labile mood
- pressured speech
Do those symptoms sound like a very pleasant person to be around? No! Irritable, tearful, agitated, and restless symptoms sound a lot like ‘Roid Rage to me!
Many others have created memes about how prednisone changes your mood. Here’s one of my favorites!
Fact #6: Psychiatric Disturbances (Mania and More)
According to the University of Cambridge, corticosteroid-induced psychiatric disturbances include (but are not limited to) mania, depression, psychotic or mixed affective states, cognitive deficits, and minor psychiatric disturbances (irritability, insomnia, anxiety, labile mood).
Fact #7: Mood Changes are Not Caused by Testosterone
A common belief is that the mood changes that are caused by ‘roid rage are caused by testosterone. However, this is a myth. Contrary to popular belief, testosterone is not causing the mood disorders.
Instead, according to researchers at the University of Cambridge, it is because of HPA axis dysregulation: “A dysfunction in glucocorticoid receptors is integral to the HPA abnormalities of mood disorders. Antidepressants and mood-stabilizing drugs can upregulate glucocorticoid receptors by restoring glucocorticoid function.”
HPA Axis means the hypothalamic-pituitary and adrenal glands. This is the cycle that your body goes through to make cortisol.
Therefore, please, do not allow yourself to think that your mood changes are due to increased testosterone. Testosterone and male hormones, androgens, have nothing to do with the mood changes while on prednisone.
Instead, it’s the stress hormone cycle (HPA Axis) being messed up by prednisone.
Conclusion: It’s Not You!
Dismissing mood changes as a consequence of eating too much is incredibly harmful. It delegitimizes the true suffering prednisone warriors have from these terrible mood changes.
I receive a phone call at least once a week from someone previously healthy, who suddenly has disabling mood changes from anxiety and depression to psychosis! It has absolutely no relationship to their diet or food intake.
In fact, they are usually just starting steroid use and haven’t even had the appetite changes hit them yet. It is just because of their steroid intake.
If somebody is dismissing your mood changes as,
“It’s all your fault”, “You’re a terrible person!”, “I’m going to divorce you!”, “I’m going fire you!”
or whatever consequence others are threatening you with right now, I want to say that I am truly sorry you are going through this.
I am sorry! Prednisone and other glucocorticoids are miraculous medications, but they come at a huge cost. The expense of your mood. These mood changes are real, disabling, and NOT caused by you.
Remember: It is not you! It is the drug.
Prednisone dysregulates your systems, and it causes a lot of mood changes. I have been where you are. Unfortunately, taking this medicine was a life-or-death situation for me. I will admit it saved my life, although it caused what seemed like a million additional issues!
What Should You Do?
Feel free to share this article with your family, boss, friends, and those around you who are affected. Sharing information about this drug with others could help them understand your plight better.
When people understand that their loved one is dealing with side effects to a medication, it can lead to empathy.
However, even if they do not understand or show empathy, do not forget that the symptoms are not your fault!
There is hope!
It takes time, and you might need to take other medications to help you cope.
But there is hope. Things will get better!
- Effects of glucocorticoids on mood, memory, and the hippocampus. Treatment and preventive therapy – PubMed (nih.gov)
- Future therapeutic targets in mood disorders: the glucocorticoid receptor | The British Journal of Psychiatry | Cambridge Core
- Psychiatric Adverse Effects of Corticosteroids (mayoclinicproceedings.org)
- Glucocorticoids. Mood, memory, and mechanisms – PubMed (nih.gov)
- Psychiatry.org – What Are Bipolar Disorders?
- What I Wish My Family Knew About Prednisone Side Effects
- Adverse Mental Side Effects of Prednisone
- What’s the WORST Side Effect of Prednisone💊?
- Am I Crazy? The Psychiatric Side Effects of Prednisone – Dr. Megan (prednisonepharmacist.com)
- 3+ Ways to Cope with Prednisone Mood Swings – Dr. Megan (prednisonepharmacist.com)
- Is Prednisone a Steroid? – Dr. Megan (prednisonepharmacist.com)
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