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Anabolic steroids are generally well accepted to have mood elevating effect. In fact, many of those using steroids become more confident and aggressive. Steroids may cause explosive bouts of aggression called “roid rage.”
Psychological reactions to steroids may differ among those on steroids for long. Such people are more prone to aggression and depression (mood swings). Further, the risk of depression or feeling low is higher when the user is off-cycle and on PCT (post cycle therapy).
Some users are also more prone to the so-called estrogen rebound reaction. Thus more probable to feel broke when not on steroids. These ups and downs in mood also explain why some become dependent on steroids and never stop taking them.
Although individual sensitivities matter a lot, however, on prolonged use most users will feel changes in the mood. Those on the higher doses or multiple steroids are more probable to develop depression when not taking steroids.
As the research shows that regular use of anabolic steroids may lead to different psychiatric issues in some individuals. Thus doctor may prescribe antidepressants. However, it must be understood that anti-depressants are very complex drugs with very unpredictable effects. Anti-depressants may cause drowsiness, insomnia, muscle cramps, changes in blood pressure, weight gains, changes in mood. Mixing anti-depressant with anabolic steroids will have unpredictable results, and there is no large-scale study to prove the safety of combining these drugs.
It is extremely rare for anyone to develop depression during the first year of use of steroids. However, with time things may change. Many steroids users may feel depressive when not on a AAS cycle.
Depression more commonly results due to discontinuation of steroids. However, if you are already experiencing side effects from steroids, it is better to take a break. As far as depression is concerned, it is a good idea to have an expert opinion, that is, consult a specialist.
In many cases, the doctor would try to treat depression without drugs. Research shows that in mild to moderate depression, psychotherapy or cognitive behavior therapy is better than drugs. Whereas, drugs are reserved for severe depression.
Nonetheless, if depression is very severe like having suicidal thoughts or feeling of complete worthlessness, it is better to take antidepressants. Some limited research indicates that antidepressants can help those living with steroid-related depression when therapy is started early enough.
Short-term steroid use will not cause dependence or psychiatric issues like depression. However, discontinuation of steroids after prolonged use increases the risk of major depression. Steroids and anti-depressants must not be mixed as it may have unforeseeable consequences for health. Primary approach for treating such kind of depression should be without the use of antidepressant drugs (psychotherapy, practicing mindfulness, even changing physical activities and hobbies). Drug therapy with antidepressants should be strictly reserved for severe cases. Finally, it is important to share everything with the doctor including steroid use so that treating physician takes a right decision.