Methamphetamine abusers often complain of feelings of depression that can complicate accurately diagnosing these individuals during treatments for methamphetamine abuse. This article presents an examination of temporal associations between documented methamphetamine use and reported ratings of depression among 162 gay and bisexual male methamphetamine abusers who participated in a 16-week randomized clinical trial of four behavioral therapies for methamphetamine abuse. Methamphetamine use was measured using thrice-weekly urine samples analyzed for drug metabolite. Self-reported depressive symptoms were collected weekly using the Beck Depression Inventory (BDI). At treatment entry, 73.2% of participants rated their depressive symptoms as mild or higher in severity (BDI>or=10), with 28.5% reporting BDI scores in the moderate to severe range (BDI>or=19). All participants reported significant decreases in depressive symptoms from baseline through the end of treatment, regardless of treatment condition, HIV status, or mood disorder diagnosis. A mixed regression model showed methamphetamine use for up to 5 days prior to the BDI score strongly predicted depressive symptoms (F1, 968=18.6, P<.0001), while BDI scores had no significant association with subsequent methamphetamine use. Findings show that behavioral methamphetamine abuse treatment yields reductions in methamphetamine use and concomitant depressive symptom ratings that are sustained to 1 year after treatment entry.