7 ways to deal with prednisone-induced anxiety


Prednisone can be a game-changer in stabilizing your IBD, but it can also mess up your mind.

If you live with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, you have probably already come across the medication prednisone. Part of a class of corticosteroids called glucocorticoids, prednisone is used to suppress the immune system and fight inflammation in the treatment of various medical conditions.

Having lived with Crohn’s disease for 15 years, I have been prescribed prednisone several times. I can say for sure that this drug does what it is supposed to do.

It was a crutch during pushes as I lost weight faster than I could keep up with. It also helped me tremendously with the relentless abdominal pain I experienced during the relapses.

Although it is often successful in stabilizing serious medical conditions, there are many side effects. One of these side effects can be anxiety.

In the IBD Healthline community, where I serve as a community guide, I read a wide range of member testimonials about prednisone. Often times, they are confused as to why the sudden anxiety arises. It is a drug to treat their inflammation and disease management, after all. Still, it can be a double-edged sword.

However, there is an explanation for the anxiety that occurs when taking prednisone. More importantly, there are things you can do to lessen this uncomfortable effect.

Research shows that mild to moderate reactions, like anxiety, occur in about 28 percent people who use corticosteroids, such as prednisone.

In another study, 11.3 percent of participants experienced anxiety or depression while taking a glucocorticoid.

The researchers concluded that the most important risk factor for developing a psychiatric symptom is the dosage, but note that it is still not possible to predict who will have side effects related to psychiatry.

But why does this happen? One explanation for the anxiety that can accompany the use of prednisone is that it can disrupt the body’s natural response to stress.

When a stressful event triggers the human body, the adrenal glands release the stress hormone cortisol, triggering a cascade of bodily mechanisms behind the scenes to deal with the stressor.

Two important receptors in this process are mineralocorticoid receptors (MR) and glucocorticoid receptors (GR).

Taking exogenous glucocorticoids (not naturally made in the body), such as prednisone, can compensate for the balance of these receptors, which can affect emotional regulation and cognition.

It’s not uncommon for me to chat with a friend or client who suffers from anxiety as a side effect of prednisone. Sometimes related side effects like fast heartbeat and difficulty sleeping can occur which add another layer that is difficult to deal with in daily life with this drug.

Fortunately, prednisone isn’t prescribed for long-term use, so anxiety should improve with each tapering. However, if you experience anxiety while taking prednisone, there are supportive treatments that can help you now.

If your anxiety or other symptoms are severe, always tell your doctor.

Adjust the timing of the dose

Using chronotherapy, a technique of scheduling doses at certain times to minimize the side effects of a drug, can help reduce anxiety resulting from prednisone use.

It is important to never suddenly stop taking prednisone or drastically change your dosing schedule. Always discuss your anxiety symptoms with your doctor to find out what to recommend.

Get a good night’s sleep

Have you ever had a terrible night and the next day you feel nervous and nervous?

Now imagine that, the more anxiety that prednisone can cause, and you have a roller coaster day on your hands.

Sometimes prednisone causes difficulty falling or staying asleep, so you’ll want to practice good nighttime routines and good sleep hygiene to be better prepared for your day.

Practice breathing

Your breathing is one of the most powerful tools for regulating your emotions.

A 2018 study have found that slow breathing techniques appear to improve the parasympathetic nervous system, the part of your nervous system that is responsible for establishing and maintaining a state of calm. Breathing also aided the emotional management and psychological well-being of study participants.

One very accessible technique is box breathing, which involves inhaling slowly for a count to 4, holding your breath for a count to 4, and exhaling for a count to 4.

Eat Foods That Relieve Anxiety

Some foods contain substances that are naturally soothing to the body.

For example, a research review showed that L-theanine, an amino acid found in green tea, can help relieve anxiety. Keep your kettle on to relieve that anxiety!

Another study found that tryptophan, an amino acid found in turkey, eggs, and cheese, significantly reduced anxiety, depression, and irritability in study participants.

Think about supplements

Certain herbs and plants, such as valerian root and ashwaganda, can help reduce anxiety and sleep problems.

You can also find “sleeping tea” or “bedtime tea” in your grocery store that contains a blend of naturally relaxing herbs and spices.

I recently started using sleepy tea and ashwanghda to relieve my anxiety and help me fall asleep more easily when I need to. Now I make sure I always have them in stock.

If you are considering taking supplements, first talk to your doctor or pharmacist for possible drug interactions.

Change the cone, if necessary

As always, your doctor should be included in any decision to change your glucocorticoid treatment. However, it is possible that if you are doing otherwise well with the medicine, your doctor may find it appropriate to reduce the treatment time faster than originally intended.

Try a different type of glucocorticoid

Although prednisone is a very common glucocorticoid, there may be others that don’t cause you anxiety.

Discuss other possible treatments with your doctor.

Anxiety can make day-to-day life a challenge, so it’s important to find strategies that work to lessen the effects of prednisone.

Always see a doctor, therapist, or other healthcare professional if you need help managing anxiety.

Remember, since prednisone cannot be taken long term, the end is always near. Keep the finish line in mind!

Alexa Federico is an author, nutritional therapy practitioner and paleo autoimmune coach who lives in Boston. Her experience with Crohn’s disease inspired her to work with the IBD community. Alexa is an aspiring yogi who would live in a cozy cafe if she could! She is the guide for the IBD Healthline community and would love to meet you there. You can also connect with her on her website or Instagram.

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