Post-stroke depression

Post-stroke depression is a form of depression that can develop after a stroke, and it affects both recovery and the overall quality of life of the people who have it. Its symptoms match those of major depression: a low or sad mood, loss of interest or pleasure, disturbed sleep, tiredness, changes in appetite, guilt, poor concentration, restlessness or slowing, and sometimes thoughts of death or self-harm. Reported incidence runs from about 18 to 33 percent, though it is often missed because stroke and depression share symptoms. It is linked especially with strokes of the basal ganglia or the front of the brain, and proposed mechanisms include glutamate toxicity, disturbed stress-hormone regulation, weakened neurotrophic support and lowered monoamine levels. Screening is advised as a routine part of stroke care, and treatment can include SSRIs, SNRIs, tricyclic antidepressants or cognitive behavioural therapy.