Is ‘Roid Rage’ Real? How Steroids Affect Emotions and Behavior

“Roid rage” is a controversial term. Some experts and fitness websites say that roid rage doesn’t exist, or that steroids aren’t related to aggression. But many medical studies and research have shown a link. So we’re here to provide an evidence-based explanation of the psychiatric symptoms related to steroids.

What is ‘roid rage’?

“Roid rage” is a phenomenon of anger and agitation that occurs with steroid use. The word “roid” in roid rage is an abbreviation of the word “steroid.” This refers to anabolic-androgenic steroids, also called anabolic steroids. People sometimes use these steroids to enhance athletic performance and increase muscle mass. They’re different from prescription steroids used for medical conditions. 

Many studies have compared the behavior of people who use steroids with those who don’t. They show that people who use steroids present more irritability and unprovoked aggression. Steroid use also increases the risk for other psychological problems, which we get into a little later.

Do steroids make people aggressive?

Some people who use steroids don’t experience significant side effects. But for others, they can be severe, including violent behavior toward other people. More specifically, people who use steroids have reported more:

• Anger

• Verbal arguments

• Violence toward significant others

But it’s not clear if steroids cause aggression by themselves. Some experts have identified other trends in those who are more aggressive with steroid use. Aggressive behavior while taking steroids could be partially explained by:

• The personality type of the average person who uses steroids

• Overlapping substance use 

• Pre-existing psychiatric conditions

What do 'roid rage' symptoms look like?

The most common descriptions of “roid rage” symptoms are unprovoked aggression and irritability. The timing and frequency of these symptoms vary from person to person. They can occur in just one episode after someone takes one dose of steroids, or they can take more time to develop. They can also be ongoing in a person who routinely takes steroids. 

Roid rage can be unpredictable, said Carrie Allen, PharmD, BCPS, a pharmacist who specializes in psychiatric concerns and a longtime fitness instructor. 

“Roid rage is similar to living with someone who has extreme anger management problems, or someone who becomes violent when they drink,” Allen said. “You don’t know exactly when or how a change in behavior is going to happen, but you know you wish you were anywhere else but near them when it occurs.” 

But steroids are also linked to many other psychiatric symptoms. Many of these symptoms can be an underlying reason for rage responses, as well.

Psychiatric symptoms related to steroids are:

• Anxiety

• Depression

• Mania and hypomania, which are states of high energy and intense emotions, like in bipolar disorder  

• Psychosis (delusional thinking)

• Impulse control problems

• Difficulty sleeping

• Changes in sexual interest

• Cognitive decline, which is a decrease in the ability to remember, think, or plan

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Not everyone who uses steroids has psychiatric symptoms. But people who use steroids are more likely to have them. In fact, they’re more likely to have multiple psychiatric problems. These can even include personality disorders.

Psychiatric symptoms sometimes get better if steroids are stopped. But for other people, symptoms can linger even after they don’t use steroids any longer.

Which steroids lead to 'roid rage'?

The steroids that lead to “roid rage” are anabolic steroids. These aren’t the same as corticosteroids like prednisone. 

Corticosteroids are medications that behave similarly to cortisol and other natural hormones in the body. They’re used for many different types of medical reasons. Corticosteroids also carry a risk of emotional and behavior problems, but not in the same way as anabolic steroids. 

Anabolic steroids are similar to the body’s hormone testosterone. They build lean muscle and make some people stronger or faster. They’re also known as “appearance and performance-enhancing drugs.” Doses of these drugs can be in the range of 5 to 100 times the amount of natural testosterone in the body. 

Some researchers think that higher doses of anabolic steroids are linked to more aggression. But other experts didn’t find a link between dosage and side effects — in either bodybuilders or average people. There are likely many factors that make the research complex.

Anabolic steroids come in several forms, including: 

• Pills

• Injections

• Gels and creams 

• Implanted pellets 

Testosterone is often the active ingredient in gels, creams, and pellets. Pills and injections have a variety of testosterone-like drugs, though. The most commonly used steroids in pill form are:

• Methandienone (Dianabol)

• Oxandrolone (Anavar)

• Oxymetholone (Anadrol)

• Stanozolol (Winstrol)

• Testosterone (Restandol)

Commonly injected steroids include:

• Nandrolone (Deca-Durabolin and Durabolin)

• Testosterone (Agovirin, Depo-Testosterone, and Retandrol)

• Boldenone (Equipoise)

What to do if someone has 'roid rage'?

If someone you know is showing signs of “roid rage,” don’t confront them while they’re angry. Emotions and situations can change quickly. 

“I’ve seen it range from irritability to laughing, followed immediately by crying to punching people or throwing things,” Allen said. “Beyond that, I’ve seen all of these behaviors come out in less than 24 hours in the same person.” 

Think about the safety of yourself and others. Consider alerting authorities if circumstances are dangerous. If you’re close to the person, you may want to encourage them to get the help of a mental health professional. And it’s important to get help for your own mental health if their behavior upsets you.

When to see a professional

If you’re experiencing “roid rage,” get help from a healthcare professional. This could be a primary care provider or a mental health professional. And get emergency medical care if you have:

• Thoughts of harming yourself or others

• Erratic or impulsive behavior that doesn’t feel like you

• Chest pain

• Racing heartbeat

• Difficulty breathing

• Intense headache

• Any concern that your physical or mental safety is in danger

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Written by:

Katherine Krive, DO

Katherine Krive, DO, is a freelance medical writer and editor. She is also a psychiatrist who has practiced in hospital, academic, and community settings.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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