Men tend to be more aggressive than women, a characteristic that has been partly attributed to higher androgen levels. Physiologically, androgens are known to act on the amygdala and hypothalamus, areas of the brain involved in human aggression. They also affect the orbitofrontal cortex, an area involved with impulse control. Steroid abusers commonly report increases in aggression (irritability and bad temper) when taking anabolic/androgenic steroids. In fact, among the illicit steroid-using community, these drugs are often differentiated from one another with regard to their aggression-promoting properties. Many athletes in explosive strength sports even specifically favor highly androgenic drugs such as testosterone, methyltestosterone, and fluoxymesterone due to their perceived greater abilities to support aggression and the competitive drive. While some association between steroid use and aggression is understood, the magnitude of this association remains the subject of much debate.
The psychological effects of escalating dosages of testosterone esters have been examined in a number of placebo-controlled studies. At therapeutic levels, no adverse psychological effects are apparent. If anything, testosterone replacement therapy tends to improve mood and sense of well-being. When used at a contraceptive dosage (200 mg per week), again, no significant psychological effects are seen. As the dosage reaches a moderate supratherapeutic range (300 mg per week), psychological side effects such as aggression began to appear in some subjects, but these reports remain mild and infrequent. At a dosage of 500 to 600 mg per week (5 to 6 times the therapeutic level), mild increases in aggression and irritability are frequently reported. Approximately 5% of subjects displayed manic or hypomanic behavior in reaction to this much testosterone, although the vast majority of people still exhibited minor or no psychological change.
One extensive placebo-controlled study furthers our understanding of the psychological effects of steroid abuse, often characterized by extreme doses and multi-drug combinations, through its examination of a group of 160 regular users before and during the selfadministration of a steroid cycle. A placebo group was also examined, which consisted of 80 people that were unknowingly taking counterfeit medications. Extensive psychological evaluations were taken using System Check List-90 (SCL-90) and the Hostility and Direction of Hostility Questionnaire (HDHQ). Those using placebo steroids did not notice any significant psychological changes. Steroid abuse, however, was associated with higher levels of hostility in all HDHQ measures, with particular increases in acting out, criticism of others, paranoid hostility, guilt, self-criticism, blaming of others, blaming of self, and overall hostility. SCL-90 ratings were also high during steroid abuse for obsessive compulsiveness, interpersonal sensitivity, hostility, phobic anxiety, and paranoid ideation. Hostility measures tended to increase significantly as the level of abuse escalated from light to heavy, although no violent behavior was reported.
Wlliam Llewellyn (2011) - Anabolics