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Depression is a common problem among persons with TBI and is amenable to pharmacological intervention (Alderfer et al. 2005; Chew and Zafonte 2009; Warden et al. 2006). Treatment of depression may alleviate not only the mood disturbance but also reduce other neurobehavioral disturbances such as impulsivity, aggression, and self-injurious behaviors (Janowsky and Davis 2005). Although many factors (e.g., sleep disturbance, fatigue [anergia], difficulty concentrating, anhedonia [apathy]) may produce or contribute to apparent depressive symptoms, when there are sufficient symptoms (or behavioral equivalents) to merit a diagnosis of depression, an antidepressant treatment should be initiated. Apathy can be misinterpreted as depression and should be considered in the case formulation (see below).

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