Results from a 2-year (4 waves) longitudinal study show strong evidence for patient decline and high levels of depressive symptomatology among caregivers. Female caregivers reported high, stable rates of depressive symptomatology throughout the study, whereas male caregivers exhibited significant increases in depression over time. Cross-sectional multivariate analyses revealed significant positive relationships between depression and number of patient problem behaviors, negative social support, and concern about financial resources; negative relationships were found between depression and social support, quality of prior relationship, and satisfaction with social contacts. Three significant independent predictors of change in depression were found: Lower depression scores at Time 1 were related to increases in depression over time; men were more likely than women to experience increases; and a decline in social support resulted in increased depression.