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Adverse Mental Side Effects of Prednisone

Adverse Mental Side Effects of Prednisone

This article is part of a series of stories of Prednisone Warriors sharing their experience with prednisone side effects. In response to a video I posted on Facebook, Gina shares her experience while she is on prednisone. It not only affects her physically, but she also confirms how prednisone and other steroids like hydrocortisone and methylprednisolone made her mental health terrible!

I Wish I Had Known About the Adverse Mental & Emotional Side Effects of Prednisone


I’m so glad to hear a professional acknowledge the mental and personality side effects of prednisone and other steroids. I have Congenital Adrenal Hyperplasia, a form of adrenal insufficiency, and the steroid of choice for it is hydrocortisone (HC).

I always felt terrible on it physically and mentally. As with the young woman you speak of in the video, I have always been a very calm, quiet person.

Psychological Effects of Prednisone

That changed dramatically when I started taking HC after my CAH diagnosis at age 33.

Before long I began having depression from it which was initially just blown off by my doctor. Then I was prescribed different antidepressants which only made me worse. I also started having anger and rages.

I am a person who had hardly ever been really angry in my life, let alone raged.

Thereafter I started having hypomania and once I had full-blown psychosis and ended up in the psych ward for a week. Once the rage and mania were over, I felt so ashamed and guilty for my behavior.

Uncontrollable Psychological Cycle from Steroid Side Effects

It truly was uncontrollable and just not me at all, but I still felt so much remorse.

I seemed to be a rapid metabolizer of HC and then just as suddenly, I would hit the threshold of where my HPA detected there was too much HC in my system and the hypomania and build-up to rages would start.

Then we would cut it back and I would crash and hit the depths of depression.

The depression caused suicidal ideation sometimes and the mania made me impulsive and the rage made me so angry with the whole situation that if I had not been over 30 years old when it all started and knew that this was not me, the intensity of the feelings was so strong that I may have acted on them.

We tried prednisone for a while for the long-acting stability of it, but it was a total nightmare of depression.

Now: stable on methylprednisolone?

Now 30 years later, I am on 2-4 mg. of methylprednisolone daily. It keeps me pretty stable, but there are still times when it gets out of whack if I’m sick or have to stress dose, and when I hit the peak dose for sickness or am tapering down,

I will have short-lived minor episodes of anger followed by a day or two of depression. Even the short-lived episodes are absolutely miserable, but for me, it seems to be unavoidable at times. I really do hate steroids, the weight gain, moods, insomnia, and all the rest that goes with them no matter how hard I try to keep them balanced, but I would die without them, and without the right dose, I have no quality of life.

I sure wish I had known about the very adverse mental/emotional side effects and had had support instead of being treated as if I had just suddenly spun into a nightmare of depression and anxiety. Something I had never experienced before in my life. It was absolute hell. I’m surprised I’m even still alive.

From Dr. Megan:

Please remember that it’s not you, it’s the drug! If you are feeling like Gina did, there is help. You aren’t crazy and you deserve all the love and compassion anyone would give someone treated with a medical condition.

Do you have a Prednisone Warrior story you want to share?

Contact Dr. Megan and we can feature it!

Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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