Prednisone can be a game-changer for stabilizing your IBD, but it may also mess with your mind.

Share on Pinterest
The Good Brigade / Getty Images

If you live with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, you’ve likely come across the drug prednisone at some point. Part of a class of corticosteroids called glucocorticoids, prednisone is used to suppress the immune system and combat 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 with certainty that this drug does what it is supposed to do.

It has been a crutch during flare-ups when I had been losing weight quicker than I could keep up with. It has also helped me dramatically with the unrelenting abdominal pain I’ve experienced during flares-ups.

While it’s often successful in stabilizing severe medical conditions, there are many side effects. One of those side effects can be anxiety.

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

However, there is an explanation for the anxiety that happens while taking prednisone. Even more importantly, there are some things you can do to ease this uncomfortable effect.

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

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

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

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

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

Two receptors important in this process are mineralocorticoid receptors (MRs) and glucocorticoid receptors (GRs).

Taking exogenous (not made naturally in the body) glucocorticoids, like prednisone, can offset the balance of these receptors, which can alter emotional regulation and cognition.

It is not uncommon for me to chat with a friend or a client who is experiencing anxiety as a side effect of prednisone. Sometimes, related side effects, like rapid heartbeat and difficulty sleeping can occur, which adds another challenging layer to manage daily life on this medication.

Luckily, prednisone is not prescribed for long-term use, so the anxiety should get better with each taper. However, If you are experiencing 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 involving scheduling dosages at certain times to minimize side effects of a medication, may help lessen anxiety resulting from prednisone use.

It’s important to never abruptly stop taking prednisone or to drastically change your dosage schedule. Always discuss your anxiety symptoms with your doctor to find out what they recommend.

Get a great night’s sleep

Have you ever had a horrible night’s sleep and the next day you feel jittery and on edge?

Now picture that, plus the anxiety that prednisone can cause, and you have a rollercoaster of a day on your hands.

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

Practice breathwork

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

A 2018 study found that slow-breathing techniques seem to enhance the parasympathetic nervous system, the part of your nervous system that is responsible for establishing and remaining in a calm state. Breathwork also promoted emotional management and psychological well-being in study participants.

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

Eat foods that ease anxiety

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

For example, one research review showed L-theanine, an amino acid found in green tea, may be supportive in relieving anxiety. Keep your tea kettle going to ease that anxiety!

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

Consider supplements

Some herbs and plants, like valerian root and ashwaganda, can aid in reducing anxiety and sleep problems.

You can also find “sleepy tea” or “bedtime tea” at your grocery store that contains a mix of naturally relaxing herbs and spices.

I recently starting using both sleepy tea and ashwanghda to support my anxiety and to help me get to sleep easier when I need it. Now I make sure to always have these stocked.

If you’re considering supplements, talk with your doctor or pharmacist first to learn about any possible medication interactions.

Change the taper, if appropriate

As always, your doctor must be included in any decisions to alter your course of glucocorticoids. However, it’s possible that if you are doing well otherwise on the medication, your doctor may feel it is appropriate to taper on a quicker schedule than originally planned.

Try a different type of glucocorticoid

While prednisone is a very common glucocorticoid, there may be others that do not cause anxiety for you.

Discuss other possible treatments with your doctor.

Anxiety can make daily living a challenge, so figuring out strategies that work to mitigate the effects of prednisone is important.

Always talk with a doctor, therapist, or other healthcare practitioner 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 autoimmune paleo 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 coffee shop if she could! She’s the Guide in the IBD Healthline community and would love to meet you there. You can also connect with her on her website or Instagram.