Recent data show that around 90 percent of people who menstruate experience symptoms of premenstrual syndrome (PMS), which could include feeling a bit emotionally topsy-turvy. So how do we know if our pendulum of feelings is related to typical stress, our cycles, or a mood disorder? Here’s 4 questions to answer.

We all have ups and downs of mood. This is a part of being human. But constant emotional volatility could be a sign of something else. If you’re altering your mood with substances like alcohol, the dramatic changes of a high or buzz followed by withdrawal or a hangover might lead to swings in your state of mind. Check your caffeine consumption, too. That late-afternoon cold brew could be the culprit.

Constant mood fluctuations could be a sign of something else, however. If you’re in your 30s and 40s, there’s a chance it’s perimenopause. This stage begins several years before we actually stop menstruating, and we usually don’t realize it. Our estrogen levels can spike and dive a bit more sporadically during this time, causing fluctuations in mood. But it can also be a sign of bipolar mood disorders, anxiety and/or depression – which you should definitely talk to your medical provider about it.

Struggles or changes that are accompanied by big life events (like a divorce, job loss, move, pandemic) are completely normal. And grief over the death of a loved one — human or pet — can bring on a range of emotions. But, we all just get a dose of the blues sometimes. We’re more vulnerable to a down-in-the-dumps frame of mind right before we get our periods. So experiencing a little bit of extra emotion is completely normal at this time.

What isn’t so normal is if you feel hopeless or devoid of energy on the regular or for weeks and weeks. If so, depression is something you need to consider. It is also a commonly reported side effect of birth control pills, so if you’ve recently switched brands you should talk to your medical provider.

If we have the rare snippy moment or just need our space, the people who love us understand and cut us some slack. And we do the same for them. This is an important part of life.

But long-term patterns could cause major relationship changes, and patterns may be a sign of a mood disorder. Watch for patterns, and then talk to a medical provider about your mood.

Work or school can be chaotic with meeting deadlines and even dealing with people’s BS. Tension can lead anyone to react in frustration, feel more sensitive to criticism or need more time than usual to complete a to-do list.

But if you’re regularly struggling to get out of bed or complete everyday tasks, that’s a concern.

Feeling drained of energy before or during your period is common, but exhaustion throughout your cycle could be a symptom of a health condition such as endometriosis, polycystic ovary syndrome, or chronic fatigue syndrome.

Long-term and severe low energy could also be a sign of depression. Paralyzing periods of procrastination or worry about work performance could be a sign of anxiety.

If you’re always down the second half of the month or are irritable right before you start a period, this could be associated with hormones. If the mood swings are erratic and not able to be tied to a certain part of your cycle, it’s unlikely they’re tied to hormonal shifts. Tracking your shifts in mood can help you determine if they’re tied to your menstrual cycle