When Prednisone Turns You Into a Walking Mood Swing: A Chef’s Comically Chaotic Reality

There are few things more humbling than stepping onto the 9:20 a.m. train to New York expecting an almost private ride, only to walk straight into a mob of sports fans who have collectively decided that this, apparently, is their train. Loud, excited, already pre-gaming for whatever match or game they were heading to. Meanwhile, I stood there blinking like a baffled tourist wondering why the universe decided to pack this particular train with every coughing, sneezing, throat-clearing human in the tri-state area. I wedged myself into a window seat, silently thanking the transportation gods, but the second I sat down, the coughing chorus launched. I just stared ahead thinking, “Fantastic. This is how I go—not from sarcoidosis, not from heart failure, but because Carl from Section 208 couldn’t be bothered to sneeze into his elbow.”

Two days later, I was, unsurprisingly, sitting in my doctor’s office with an upper respiratory infection and the kind of fatigue that makes you think about drafting your final will. My doctor handed over antibiotics and then casually nudged my prednisone dose up to 40mg, otherwise known as the setting where my brain turns into a psychological carnival ride. I’ve been on prednisone for twenty years now—yes, twenty—and while you’d think two decades would make me immune to its antics, the drug still shows up like an uninvited roommate who eats all your snacks and rearranges your emotional wiring.

For the record, prednisone has never given me the physical side effects everyone warns you about. No moon face, no runaway appetite, no water-retaining Michelin Man moment. No, my body took one look at the warning list and said, “Let’s skip the standard options and go straight to psychological fireworks.” My wife lovingly calls them my “pred moments,” which is her diplomatic way of acknowledging that the drug sometimes turns me into an emotional tornado wearing a very convincing human costume. Within 24 hours of hitting 40mg, I could feel the familiar shift—the irritability, the misplaced rage, the sudden internal committee meeting between personalities I didn’t even audition.

My favorite symptom, if we can call it that, is the spontaneous fury that appears out of thin air. Someone bumps into me? Fine. Someone bumps into me and apologizes? Suddenly the universe tilts sideways and I’m mentally drafting angry speeches. The apology does it every time. No apology? No problem. Apology? Boom. Prednisone flips a switch and I’m ready to file emotional grievances.

But after twenty years with this medication—twenty—I’ve gotten pretty good at spotting when the demon is clocking in. There’s this tiny moment where I feel the anger bubbling up, and I have to remind myself, “This isn’t you. This is prednisone, the lifelong companion you never asked for but somehow ended up stuck with forever.” If you’ve ever found yourself mid–emotion explosion over something trivial while on prednisone, know this: it’s not you and you’re not losing your mind. It’s the drug holding the controls, and it is a terrible driver.

Thankfully, I’m back down to my usual 10mg, which is my version of “mostly functional with occasional chaos.” Even on that dose, if I’m tired, the demon likes to poke its head out just to remind me it owns real estate in my brain. But I’m wise to it now. Twenty years will do that. And since prednisone is clearly my permanent roommate for the rest of my life, I’m learning how to coexist without letting it take over the whole house.

So here’s to all my fellow chronic-illness warriors and long-term prednisone survivors: I see you, I salute you, and I absolutely understand the emotional gymnastics you perform daily. We may be stuck with this medication for life, but at least we can laugh at the madness together.

If you’ve ever ridden the prednisone roller coaster or survived a commute filled with contagious chaos, drop a comment or subscribe. I’d love to hear your stories too.