We explored the relationships between family communication and caregiver depression in families with a member in the middle phase of Alzheimer’s Disease. We expected that caregivers who focused on problem solving with their families would report fewer symptoms of depression than caregivers who continued to talk with family members about the illness experience. We conducted lag sequential analysis and sequence repetition analysis to examine the relationships between the communication patterns and caregiver depression. The findings suggest two underlying communication processes—cooperation and competition about illness talk. We propose that clinical interventions aimed at getting caregivers and family members to talk more collaboratively about any issue may be more effective than trying to reduce the focus on illness talk by moving the family to focus on problem solving.