Practice guidelines for the care of post-stroke patients clearly state that all patients must be assessed for the presence of depression. However, several factors can complicate the diagnosis of depression following stroke: first, language disorders due to decreased level of consciousness or fluent (Wernicke's) aphasia with comprehension deficit. Although the pathogenesis of post-stroke depression (PSD) remains unknown, a biopsychosocial approach to treatment is probably the most appropriate. The physical treatments include antidepressants and electroconvulsive therapy. Most studies have failed to find a difference in recovery when comparing patients given antidepressants versus those given placebo. Six studies have found that patients with post-stroke depression have increased mortality compared with non-depressed stroke patients. As PSD has been associated with impaired recovery and increased mortality, consideration of a preventive intervention among non-depressed patients should be discussed with the patient, the family, and the treating physician.