🌦️ Understanding Corticosteroid Mood Swings
Alison shared something that will resonate with many of us:
“Recognising that prednisone mood swings are very unpredictable is a good reminder as I feel like I am up and down so much of late. Yesterday’s swap to half hydrocortisone and half prednisone probably took a bit of adjusting too. Better day today though — I even got out to pick up my campervan that had been in for service. Felt really good to be driving it again and as the weather improves, I live in hope that I might get to use it this year!” 😊🤔
💭 Why mood can change on corticosteroids
Steroid medicines such as prednisone, prednisolone, and hydrocortisone affect many systems in the body — including brain chemistry.
When levels go up or down (for example when changing dose or type), it’s common to feel:
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Irritable or anxious one day, low or tired the next
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More emotional than usual — tears or frustration come quickly
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Sleep disturbance, vivid dreams, or early waking
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Short bursts of energy or restlessness, followed by a “crash”
These changes don’t mean you’re “losing control” — they reflect how sensitive the brain is to shifts in cortisol, the hormone steroids replace or supplement.
⚖️ Why switching between steroids can feel bumpy
Prednisone and hydrocortisone are both corticosteroids but have different potencies and timings:
| Steroid | Approx. equivalent dose (anti-inflammatory) | Typical duration of action |
|---|---|---|
| Hydrocortisone | 20 mg ≈ 5 mg prednisolone | Short-acting (6–8 hours) |
| Prednisone/Prednisolone | 5 mg | Longer-acting (12–36 hours) |
When switching or mixing them, the body’s rhythm of cortisol can temporarily feel off — like jet lag for your stress hormones. It often settles after a few days.
🌞 Tips that may help
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Keep a simple mood or energy diary — it helps you and your clinician see patterns.
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Take doses at consistent times, usually in the morning, unless advised otherwise.
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Build in gentle activity or time outdoors — small wins, like Alison’s campervan trip, really lift mood.
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Avoid caffeine or alcohol spikes if feeling restless or irritable.
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Tell your clinician if mood swings are severe or prolonged — dose adjustment or slower tapering may help.
💬 In Alison’s words
“Better day today.”
Sometimes that’s the victory — one step, one better day, one bit of normality returning.
Personality, Connection, and Mental Health

Everyone has different ways of keeping emotionally balanced. Some people need lots of contact with others, while some need quiet time to recharge. Others feel best when they mix both. Recognising your “type” isn’t about putting yourself in a box — it’s about understanding what you need to stay well.
1. The Connector
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How they thrive: by spending time with friends, family, or groups.
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Mental health benefit: being around others boosts mood, reduces anxiety, and gives a sense of belonging.
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Challenges: isolation or long stretches without company can lead to loneliness, low mood, or feeling cut off.
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Helpful strategies:
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Build regular contact into your week (calls, visits, online groups).
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Explain to family/friends that contact isn’t a “nice extra” but an essential for your wellbeing.
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Use support groups (like NAC CARES) to stay connected if health limits travel.
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2. The Reflector
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How they thrive: by having quiet, personal space to recharge after socialising.
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Mental health benefit: time alone helps calm the nervous system, reduce stress, and spark creativity.
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Challenges: may feel drained if pressured into constant social contact. Can appear “distant” to others when actually just recharging.
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Helpful strategies:
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Protect quiet time without guilt — see it as fuel, not selfishness.
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Use calming practices (journaling, meditation, walks, hobbies).
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Communicate with loved ones: “I need some downtime, then I’ll rejoin.”
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3. The Balancer
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How they thrive: with a healthy mix of both social contact and private time.
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Mental health benefit: balance allows them to enjoy connection without becoming overstimulated.
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Challenges: may tip too far one way — overbooking social time and burning out, or retreating too much and feeling lonely.
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Helpful strategies:
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Notice your signals — irritability might mean you need rest, loneliness means you need contact.
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Plan weeks with both connection (calls, visits) and rest (quiet evenings, gentle hobbies).
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4. The Helper
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How they thrive: by supporting and caring for others. Helping gives meaning and boosts self-worth.
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Mental health benefit: gives purpose and strengthens relationships.
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Challenges: may neglect their own needs, leading to burnout or resentment.
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Helpful strategies:
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Follow the “oxygen mask rule” — you can only help others if you look after yourself.
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Schedule self-care alongside care for others.
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Accept help when offered — balance is key.
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5. The Explorer
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How they thrive: through novelty, discovery, and learning. They love trying new things, meeting new people, or exploring new ideas.
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Mental health benefit: curiosity and new experiences can reduce boredom, lift mood, and spark resilience.
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Challenges: chronic illness can limit physical adventures, which may feel like a loss of identity.
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Helpful strategies:
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Adapt “exploring” to your situation — online learning, virtual tours, new books or creative hobbies.
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Set small, achievable challenges so you still get a sense of growth.
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Why this matters for mental health
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There is no “right” type. Each way of recharging is valid. Problems arise when we don’t recognise or honour our needs.
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Stress comes when needs aren’t met. A Connector without contact feels lonely; a Reflector without quiet feels overwhelmed.
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Self-awareness protects wellbeing. Knowing your type helps you explain your needs to family, friends, and even your healthcare team.
Key message for aspergillosis patients
Chronic illness can magnify these needs. Fatigue, isolation, or hospital visits may disrupt your usual coping style. Recognising whether you’re a Connector, Reflector, Balancer, Helper, or Explorer can guide you to the right kinds of support.
👉 In short: protect what restores you. Whether it’s people, quiet, balance, helping, or exploring, these are not luxuries — they are the building blocks of good mental health.
Grief and the Loss of Health in Aspergillosis
Understanding grief
Grief is usually thought of as the response to the death of a loved one, but it is more than that. Grief is the natural human reaction to any major loss — whether of a person, a role, a relationship, or one’s health.
For people living with aspergillosis, grief often arises not only from bereavement but also from the daily reality of lost health, independence, and certainty about the future. This type of grief is sometimes overlooked by others, yet it is just as valid and just as painful.
Bereavement grief vs. health-related grief
Grieving a loved one
When a person we love dies, the grief process involves:
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Remembering and honouring the relationship.
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Finding ways to carry that memory forward through photos, anniversaries, stories, or rituals.
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Adjusting to life in their absence while keeping a continuing bond.
The work of bereavement grief is therefore about preserving connection to memory and integrating loss into our life story.
Grieving health
By contrast, grieving the loss of health is about adapting to change in the present and future:
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Our body no longer works as it once did.
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Activities and roles that defined us may no longer be possible.
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Identity and self-image shift as illness reshapes daily life.
The task here is not to “hold on” to a memory, but to rebuild life around a new reality. Patients often grieve the loss of their “old self” — the person who could climb stairs, walk long distances, work, or join in family activities without limitation.
👉 Put simply:
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Bereavement grief = finding ways to remember.
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Health-related grief = finding ways to adapt.
Why health loss grief is particularly difficult
For people with aspergillosis (and other long-term conditions), this grief is uniquely challenging because:
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The loss is ongoing – illness can fluctuate, relapse, or progress, so grief is re-triggered many times.
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It is invisible – others may not see how devastating the loss of health feels, which adds loneliness.
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It is about the self – we mourn not just someone else but the person we used to be.
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It holds uncertainty – unlike death, health loss sits in a space between grief and hope, as treatments may stabilise or improve things, but may not restore the past.
How to adapt and live with health-related grief
1. Recognise it for what it is
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Naming these feelings as grief helps reduce guilt and self-blame. You are not “weak” or “failing” — you are adjusting to a major life change.
2. Give space for feelings
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Sadness, anger, frustration, and even envy are normal. Suppressing them often prolongs the pain.
3. Use safe outlets
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Talk with others who understand — family, friends, support groups, or counsellors.
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Write in a journal, make art, or use rituals (like lighting a candle or planting a tree) to symbolise change.
4. Maintain connection and meaning
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Illness may limit old roles, but it does not erase identity. People often rediscover purpose through hobbies, creativity, peer support, or volunteering.
5. Focus on what’s possible now
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Set small, realistic goals — e.g. walking to the garden, preparing a simple meal, joining a call.
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Celebrate these achievements, rather than only comparing yourself to your old abilities.
6. Care for your body
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Sleep, nutrition, and gentle movement (as tolerated) improve energy and resilience.
7. Seek professional support if needed
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If grief leads to ongoing despair, anxiety, or hopelessness, ask your GP about counselling or NHS Talking Therapies. Support is available, and you don’t have to carry this alone.
Resources
UK-based
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NHS Talking Therapies – free counselling/CBT for anxiety and depression.
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MIND – support for mental health and loss.
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Asthma + Lung UK – helpline and groups for lung disease.
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Cruse Bereavement Support – guidance on grief that can apply to non-death losses.
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NAC CARES (aspergillosis.org) – patient meetings, forums, and tailored educational resources.
International / Online
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What’s Your Grief – blogs, courses, and podcasts on different types of grief.
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The Mighty – online community sharing experiences of chronic illness and loss.
Books
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How to Live Well with Chronic Pain and Illness – Toni Bernhard.
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When the Body Says No – Gabor Maté.
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On Grief and Grieving – Elisabeth Kübler-Ross & David Kessler.
Videos
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Grieving with a Chronic Illness (YouTube).
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Living with Loss: Navigating Grief in Chronic Illness (YouTube).
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Letting Go of Grief and Guilt with Chronic Illness (YouTube).
Final message for patients
Grief from health loss is real, human, and normal. It is not about weakness, nor about giving up. It is about learning how to live differently — with compassion for yourself, space for your feelings, and courage to rebuild purpose in new ways.
While bereavement grief holds on to memory, health grief asks us to adapt. Both are valid, both are painful, and both can soften with time, support, and self-kindness.
👉 You are not alone — others with aspergillosis and chronic illness are walking the same path, and support is out there to help you carry it. 💙



