Caregiving for a person with dementia or neurodegenerative disease is associated with increased rates of depression and anxiety. As the population ages and dementia prevalence increases worldwide, mental health problems related to dementia caregiving will become an even more pressing public health concern. In the present study, we assessed emotional empathy (physiological, behavioral, and self-reported emotional responses to a film depicting others suffering) and two measures of cognitive empathy (identifying the primary emotion experienced by another person and providing continuous ratings of the valence of another person’s changing emotions) in relation to mental health (standard questionnaires) in 78 caregivers of people with dementia or neurodegenerative disease. Greater emotional empathy (self-reported emotional responses) was associated with worse mental health even after accounting for known risk factors. Neither measure of cognitive empathy was associated with mental health. A relationship between high levels of emotional empathy and poor mental health in caregivers suggests possible risk indicators and intervention targets.