Bipolar Disorder Treatment Medications The Relationship Between Steroids and Bipolar Disorder By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on June 10, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Pillbox / U.S. National Library of Medicine In her memoir "Skywriting," television journalist Jane Pauley disclosed that she has bipolar disorder. The illness appeared when she was given steroids for a case of hives, she says. The revelation refocused public attention on the relationship between steroids and manic depression. In the portion of her book excerpted in the August 20, 2004 issue of People, Pauley writes that she experienced hypomania following the first administration of steroids for her hives and depression with the second. The depression was serious enough that she was prescribed a low-dose antidepressant, and she rebounded into an agitated mixed state and rapid cycling. Her doctor explained that the antidepressant "unmasked a never-before-suspected vulnerability to bipolar depression." But, according to Pauley's account, the mood swings began with the steroids. She was hospitalized at the time and stabilized on lithium. Symptoms of Bipolar Disorder What Are Steroids? When taken in as a medication, steroids (also known as corticosteroids) are synthetic drugs that are similar to cortisol, a hormone naturally produced in the body. While the term "steroid" is typically equated with its drug form, the body also makes steroids naturally. Studies have shown that corticosteroids, like the one Pauley was prescribed, can induce psychiatric symptoms. The use of steroids is associated with mood disturbances and psychosis. Mania and depression can be triggered by the initiation as well as the withdrawal of steroids. Corticosteroids Corticosteroids are used in the treatment of a wide variety of medical conditions including: Asthma Emphysema Crohn's disease Bursitis Tendinitis Ulcerative colitis Hives Insect bites Nasal allergies Eczema Psoriasis What the Research Says Single-use steroids are highly unlikely to cause any kind of mental disturbance. Rather, it is the prolonged and steady administration of steroids that may cause these uncommon psychiatric side effects. By her own account, Pauley was taking steroids for five months before the mood swings began. A 2006 meta-analysis found psychiatric adverse effects common from steroid use, with hypomania and euphoria being the most common. Long-term use, however, has been associated with depression. It also found that the severity of the adverse effects related to the dosage. According to a 2003 case report, while the underlying mechanism is still unclear, adverse psychological symptoms associated with corticosteroid use is potentially reversible with dose reduction or discontinuation of the drug. However, treatment of psychiatric symptoms is often required. According to forensic psychiatrist Dr. Henry Lahmeyer, single-use steroids are unlikely to cause any kind of mental disturbance. Rather, more often, it is the prolonged and steady administration of steroids that may cause these psychiatric side effects. By her own account, Pauley was taking steroids for five months before the mood swings began. Another 2004 study also indicated that some of the changes noted in the hippocampus can be prevented with "selective antidepressant and anticonvulsant drug treatments" such as Eskalith (lithium). It is important to be aware of the potential psychiatric impact of steroids, and continued research holds better promise for understanding these potential psychiatric side effects. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Pauley J. Skywriting. New York, NY: Penguin Random House; 2005. Franey DG, Espiridion ED. Anabolic Steroid-induced Mania. Cureus. 2018;10(8):e3163. doi:10.7759/cureus.3163 Mazziotta J. Jane Pauley Didn’t Have Bipolar Disorder Until Age 50: ‘When I Was 49 I Was Not Bipolar’. People. Steroids. U.S. Library of Medicine. Warrington TP, Bostwick JM. Psychiatric adverse effects of corticosteroids. Mayo Clin Proc. 2006;81(10):1361-7. doi:10.4065/81.10.1361 Ingram DG, Hagemann TM. Promethazine treatment of steroid-induced psychosis in a child. Ann Pharmacother. 2003;37(7-8):1036-9. doi:10.1345/aph.1A271 Wood GE, Young LT, Reagan LP, Chen B, Mcewen BS. Stress-induced structural remodeling in hippocampus: prevention by lithium treatment. Proc Natl Acad Sci USA. 2004;101(11):3973-8. doi:10.1073/pnas.040020810 Gable M, Depry D. Sustained corticosteroid-induced mania and psychosis despite cessation: A case study and brief literature review. Int J Psychiatry Med. 2015;50(4):398-404. doi:10.1177/0091217415612735 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.