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Women with breast cancer are at increased risk of depression, and the extent to which valued activities are disrupted by one's illness has been correlated with depressive symptoms in women with early stage breast cancer. This association has not been examined in women with Stage IV (metastatic) cancer, and the temporal directionality of this relationship remains unclear. The goal of the current study was to examine longitudinal, reciprocal relationships between illness-related disruption of social and recreational activities and self-reported symptoms of depression in a sample of women living with Stage IV breast cancer.Participants were 103 women diagnosed with metastatic breast cancer. Women completed measures of depressive symptoms and activity disruption at study entry (T1) and at 3-month follow-up (T2).Activity disruption at study entry did not significantly predict changes in total depressive symptoms or in negative affective or somatic symptoms but did predict reductions in positive affect. Total depressive symptoms at study entry predicted increases in activity disruption, as did negative affective symptoms.Depressive symptoms, specifically negative affective symptoms such as sadness, may exacerbate social and recreational activity disruption in women with metastatic breast cancer. Cancer-related activity disruption may, in turn, result in reductions in positive affect. These results highlight the importance of examining specific constellations of depressive symptoms and suggest that maintaining valued activities may help to preserve enjoyment of life for patients with Stage IV cancer.