Walk into many gyms in Delhi NCR and you will find two menus. The official one lists membership plans. The unofficial one, passed between trainers and members, lists injectables, imported tablets and “cycles”. Gym drug abuse is one of India’s fastest-growing and least-discussed substance problems — and it lands in my clinic more often every year.
What are people actually taking?
The most common category is anabolic-androgenic steroids — synthetic derivatives of testosterone used to accelerate muscle growth. Around them sits a grey market: unregulated “fat burners”, thyroid hormones taken without prescription, stimulant pre-workouts, and newer compounds sold online with almost no human safety data.
Most users are young men between 18 and 35. Almost none of them think of what they are doing as drug use. That is precisely what makes it dangerous.
What steroids do to the brain
The physical risks — liver strain, cardiac effects, hormonal shutdown, infertility — are increasingly known. What is far less discussed is the psychiatric side, which is where I meet these patients.
Supraphysiological doses of anabolic steroids can produce mood swings, irritability and aggression during use. On stopping, users frequently crash into a withdrawal state marked by low mood, fatigue, loss of confidence and depression — because the body’s own testosterone production has been suppressed. This crash drives many users straight back into the next cycle. That loop — use, crash, craving, reuse — is the architecture of dependence.
Source: Pope et al., research on anabolic-androgenic steroid dependence, Harvard Medical School; ICD-11 recognises steroid-related disorders.
There is a further layer: muscle dysmorphia — a body-image disorder in which a visibly muscular person continues to perceive themselves as small. It behaves like a cousin of anorexia nervosa in reverse, and is a powerful engine of steroid dependence.
The Indian context
In India, this problem is amplified by three factors: pharmacy access without meaningful prescription checks, an unregulated supplement market where products are frequently mislabelled or adulterated, and gym culture in which the person selling the cycle is also the person the young man trusts most about his body.
When to seek help
Consider a psychiatric consultation if you or someone you know cannot stay off cycles despite intending to stop; experiences depression, rage episodes or anxiety linked to use or withdrawal; is preoccupied with perceived smallness despite obvious muscularity; or is combining multiple compounds to manage the side effects of others.
Treatment is confidential and non-judgemental. It typically involves medically supervised discontinuation, management of the withdrawal depression, treatment of any underlying body-image disorder, and — where needed — endocrinology collaboration for hormonal recovery.
FAQ
Are steroids addictive like alcohol or drugs? They can be. Steroid dependence is a recognised clinical entity — driven less by a “high” and more by withdrawal crashes and body-image reinforcement.
Can the depression after stopping steroids be treated? Yes. Post-cycle depression responds to psychiatric treatment, and managing it properly is often what finally breaks the cycle of reuse.
Will my consultation be confidential? Completely. Doctor-patient confidentiality applies fully, and no information is shared with gyms, employers or family without your consent.
