The Effects of Steroid Use

One of the more interesting findings of the highly publicized testosterone-builds-muscle study recently published in the prestigious New England Journal of Medicine is the lack of mental aggression seen among the participants of the study. This seemingly contradicts previous extensive medical documentation concerning the negative effects of anabolic steroids on psychological status, popularly known as ‘roid rage.

The finding in the NEJM study that 600 milligrams a week of testosterone didn't produce adverse mental symptoms could be due to the brevity of the study or to the fact that not everyone responds to steroid usage - or to be more precise, abuse - in the same way. For example, in a report to the Endocrine Society in 1995, researchers noted that a deficiency of testosterone in 56 men produced personality characteristics (including anger and irritability) more commonly associated with steroid excess. When those 56 testosterone-deficient men were given supplemental testosterone injections, their personalities went from surly to genial.

A different conclusion was reached in a new study published in the Australian Medical Journal (165:222-26) that reviewed the evidence concerning the effects of anabolic steroids on the mind. Recent violent acts committed in Australia and allegedly related to steroid abuse seem to have precipitated this study.

The first case centered on a 29-year-old bodybuilder who beat his wife to death using a weapon described as a claw hammer. While he committed this horrific act, his four children were in another part of the house. He then shot himself in the head. Before this incident, his home life had been described as ‘‘happy.''

This man had used steroids off and on for years, and seven weeks before the murder, he had used a steroid stack consisting of Winstrol-V and sustanon, both injectable steroids. A later urine test showed that he also used Valium, a muscle relaxant and anti-anxiety drug.

A second case involved a 22-year-old bodybuilder in Sydney. After taking a walk with a woman he had met in a nightclub, "something snapped" in the bodybuilder. He repeatedly bashed the woman's head against a wall, then proceeded to kick her while she was lying on the ground. Although several experienced police investigators described the attack as the most brutal they had ever seen, the perpetrator of this deed merely left the scene and went home to bed.

This guy had just taken an eight-week course of Deca Durabolin, an injectable anabolic steroid. He said using the drug made him feel that he had "heaps more energy." As well, he was "crankier, more aggressive, had an increased sex drive, and felt more uptight." He had stopped taking the drug for two months, then resumed its use for three weeks before the murder. He was said to have come from a caring family and had never used drugs previously. He was also said to have never been violent. Significantly, he had drunk three liters of beer in the hours preceding the attack.

The author of this Australian review notes that steroids increase feelings of self-confidence, energy and motivation, as well as improve training ability. He also claims that the mental effects of steroids follow a continuum, often dependent on how large a dose is used or whether several steroids are taken at the same time. This continuum, according to the author, consists of the following:

• Early effects are reflected in mood changes and euphoria. Confidence increases, as do energy levels, self-esteem, motivation and enthusiasm. You experience less fatigue, sleep better and have an increased ability to train through pain. Sex drive usually increases, as does irritability, anger and a "strange, edgy feeling."

• As doses increase or are taken for extended periods, a loss of inhibition occurs combined with impaired judgment, mood swings and grandiose ideas. This condition progresses until the user becomes suspicious, argumentative, impulsive and still more aggressive.

• Eventually, aggressive feelings reach a fever pitch, characterized by violent, hostile and antisocial behavior. This is full-blown ‘roid rage and can lead to self-inflicted injury, assault, divorce, domestic violence, child abuse and attempted murder. Not all people experience these feelings. Some researchers explain this paradox by suggesting that an underlying predisposition to such behavior can be brought to the surface by steroid abuse.

Another problem related to the psychological effects of steroids is what happens when the user stops taking them. Depression is common in former steroid users, who miss the elation brought on by the drugs. In fact, just about all positive mental feelings associated with steroid use reverse when one ceases taking them. The author of the Australian review says that, in some cases, violent behavior and moments of rage occur during the withdrawal phase.

Dependence on steroids can result when the user wishes to stave off loss of confidence as steroid-built muscles begin to atrophy. This dependence may also involve a modulation by steroids of brain chemicals, such as endogenous opioids, that control mood states.

An often-overlooked factor in discussions of the mental effects of steroids is how specific steroids modify behavior. For example, most studies that associate violent or antisocial tendencies with steroid use usually involve a more androgenic type of steroid, such as Anadrol-50 or testosterone. Animal studies in which mice were given a more anabolic, less androgenic steroid, such as stanozolol (Winstrol) documented no aggressive changes in behavior (General Pharmacology, 27:293-98).