Brain injury and stroke are common. Apart from causing the obvious physical symptoms like weakness/paralysis of a limb, these can also cause cognitive and almost all psychiatric disorders. Depression is however the commonest. This perhaps demonstrate the neurological basis for psychiatric disorders.

BRAIN (HEAD) INJURY

The commonest cause of head injury are motor vehicle accidents. Other causes include falls, sports injuries, violent crimes, and child abuse. The physical, behavioural, or mental changes that may result from head injury depend on the areas of the brain that are injured. For example, injury to frontal or temporal parts of the brain can result in personality change, loss of memory and problems with the use of language.

The problems which emerge can improve with time but generally patients are never able to get back to their pre-injury status.

Treatment consists of rehabilitation which involves allied health professionals like speech-language therapists, physiotherapists, occupational therapists, and neuropsychologists. They help the patient re-train and develop alternative strategies to deal with his acquired deficiencies.

STROKE (BRAIN HAEMORRHAGE)

Patients who suffer stroke are at a greater risk of developing depression. According to research, as many as 60% patients with stroke suffer from some symptoms of depression. Appropriate diagnosis and treatment of depression may bring substantial benefits to persons recovering from a stroke by improving their medical status, enhancing their quality of life, and reducing their pain and disability. Treatment for depression also can shorten the rehabilitation process, lead to more rapid recovery.

Among the factors that affect the likelihood and severity of depression following a stroke are the location of the brain lesion, previous or family history of depression, and pre-stroke social functioning. Stroke survivors who are also depressed, particularly those with major depressive disorder, may be less compliant with rehabilitation, more irritable, and may experience personality change.

Stroke survivors, their family members and friends, and even their physicians may misinterpret depressive symptoms as an inevitable reaction to the effects of a stroke. But depression is a separate illness that can and should be treated, even when a person is undergoing post-stroke rehabilitation.

Prescription antidepressant medications are generally well-tolerated and safe for people recovering from a stroke. There are, however, possible interactions among some medications and side effects that require careful monitoring. Therefore, stroke survivors who develop depression, as well as people in treatment for depression who subsequently suffer a stroke, should make sure to tell any physician they visit about the full range of medications they are taking.

Treatment for depression in stroke survivors should be managed by a a psychiatrist, who is in close communication with the physician providing the post-stroke rehabilitation and treatment. This is especially important when antidepressant medication is prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as stroke may be available.