When taken orally, the pills are tiny. Who knew they could wreak such havoc on my life?

I’ve taken Prednisone for 4 years now, with two small 3-month breaks. When at my medical worst, I’ve taken as much as 40mg of Prednisone a day. Now, my baseline is 5mg. I have to titrate up when I flare, and then titrate myself back down once my symptoms subside. At 5mg, I don’t really notice the Prednisone. But, when I have to increase to 15 or 20mgs, I see a substantial impact on my quality of life.

Typically, the side effects that I get from Prednisone include insomnia, increase energy levels (the one value-added side effect!), increased appetite, and mood swings. The insomnia and mood swings go hand-in-hand. When I don’t sleep, I become irritable and foggy. And, Prednisone typically makes me feel angry. Irritability and anger don’t make for nice bed-fellows.

I manage the mood swings naturally and attempt to minimize the damage to those around me. Sometimes, that means not replying to a text message for a few hours, taking a walk, or deep-breathing. But if the length of time that I have to take increased levels of Prednisone is beyond a couple of days, these methods don’t always work into my lifestyle. At those times, I’ll try to get away for a few days or hang out at my house more.

If my methods of self-regulation fail and I do commit social grievances for those around me, I take responsibility for them. I know that I’m not myself (and most of those around me do, as well), but I don’t excuse the behaviors. I admit where I’m wrong and work harder to prevent it from happening again. I do try to educate my family and friends about the effects of Prednisone so that when I’m on stronger doses they can be a little bit softer in their approach.

Like every other aspect of this illness, I try to be as data-driven and educated as possible. Below are a few articles (there are many) that discuss the relationship between Prednisone and affect. Hopefully, they will help someone else who is in a similar situation.

1: “The Psychiatric Side Effects of Corticosteroids.”

2: “Mood and Cognitive Changes During Systemic Corticosteroid Therapy.”

3: “Mood Symptoms During Corticosteroid Therapy: A Review.”
4: “Exogenous Corticosteroid Effects on Mood and Cognition: Case Presentations.”

2 thoughts on “Prednisone.

  1. Hey A,
    This sucks. I really hope you get to feeling better soon. I’ve been in a similar boat the last few weeks/months. Something about this part of the year really gets me. I’m so happy you still recognize your accomplishments- its so hard to do that when you get sick sometimes. Hang in there, I love reading your posts. And if you ever want to whine, because sometimes that’s just what you need to do, hit me up.
    P.S. I heard about a little 6 year old who they think might have BD. I almost cried. Any age is too young, but she’s just a baby. Thought I’d share that. It really made me sad.

  2. I remember the first time I went on Pred, 15 mg – I was so miserable and in pain I was willing to do almost anything make it stop. I did have help with the pain, but then I noticed a couple of things that I didn’t understand. I wanted food all the time, I couldn’t wait until I was hungry again to eat. I was so creative about food, and if my husband hadn’t been home, I would have gone out in the middle of the night to satisfy my Chicken McNugget craving. I gained 35 pounds in 2 months – I couldn’t understand what was happening.

    I had cheeks like a squirrel bringing nuts back to the nest – someone put their hands on each cheek and asked “What happened?”. It took quite awhile to understand that appetite in more at the base of the neck, while hunger is more in your abdomen. Then I figured, I can live with fat if I can feel good. Guess what! I realized I couldn’t live with being fat – or should I say fatter than usual.

    I finally went off but the 35 pounds is still keeping me company – like a party guest who won’t go home. If you hadn’t reminded me, I would not have remembered what Pred does to me – maybe that was what caused my donut cravings the other week. I am 5 mg a day and hope the Orencia will help me get off it completely.

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