Key message: (1) This study elucidates the adverse effects of post-stroke depression on patients in order to raise awareness of the disease. (2) This study explores the traditional Chinese medicine pathogenesis of post-stroke depression and provides new ideas for its treatment. (3) This article studies the clinical effects of psychotherapy based on five-element theory in traditional Chinese medicine in improving the mental state of patients with post-stroke depression, so as to provide reference and enlightenment for clinical treatment.