11 Conditions that Trigger a Feeling of Impending Doom

Understanding the feeling of impending doom

Feeling like something very bad is about to happen might seem like it falls under “intuition.” Or, given the fact that you’re living in the middle of a pandemic, it may be a result of constant stress. But a feeling of impending doom can also precede life-threatening medical events like a heart attack. It may be a symptom of psychological conditions like anxiety or depression.

Here’s what you need to know about the conditions that may trigger a feeling of impending doom.

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What is a feeling of impending doom?

Describing a feeling is often tough, but “impending doom is an overwhelming sensation that something terrible or life-threatening is about to happen to you or others,” says Sanam Hafeez, PsyD, a neuropsychologist and faculty member at Columbia University in New York City. “Someone might feel like they are dying, their house is about to burn down, or their plane is about to crash even if there is no apparent danger.”

Here are some of the reasons you might feel near catastrophe.

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Psychological causes

Impending doom can be a tough-to-parse symptom. You feel as if something is very wrong—but what exactly is it? “To determine whether this sensation results from anxiety or a medical emergency, there are a few factors to weigh,” says Hafeez. “If someone is in no imminent danger, no physiological symptoms accompany the sensation, and if the anxiety is present, it is likely the result of a mental health issue or trauma.” In fact, it would be very unlikely for someone experiencing a feeling of impending doom not to have accompanying physiological symptoms. These are some of the potential psychological candidates.

Depression

When you have depression, you look at the world in a different way. “Depressive thoughts are like putting on dark glasses: Things look gloomy and unpredictable,” says Susan Albers-Bowling, PsyD, a psychologist at Cleveland Clinic in Wooster, Ohio. Symptoms of a depressive episode may also include feeling hopeless or pessimistic, thoughts of death or self harm, and decreased energy and fatigue.

Anxiety

There are several types of anxiety disorders that can lead to a feeling of impending doom, says Hafeez:

• Panic disorder and panic attacks
• Generalized anxiety disorder (GAD)
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)

Why? Consider panic disorder, for instance, which is a type of anxiety disorder. People having a panic attack may feel an overwhelming sense that anxiety and fear is bubbling up and ready to spill over. That can go hand-in-hand with a feeling of impending doom, according to the National Institute of Mental Health. You may also feel physical symptoms as well, like a racing heart, sweat, chills, dizziness, and nausea. Many of these can overlap with symptoms of a heart attack.

Bipolar disorder

Impending doom may also be a feature of bipolar disorder, says Hafeez. People who have bipolar disorder experience often extreme changes in mood, energy, and activity levels. This is marked by manic highs and depressive lows. During a depressive episode, you may feel convinced catastrophe is imminent. You may also feel slow, worthless, hopeless, have trouble sleeping, and have little interest in doing much of anything.

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Conditions that can cause the feeling

“Impending doom” can be a psychological symptom that signals an emergency event. The physical symptoms, like a sudden drop in blood pressure, may signal to the brain that something is very wrong, says Hafeez. It may also be the release of hormones from the adrenal glands (dopamine, norepinephrine, and epinephrine) into the bloodstream during times of stress. Or it may be a response from your nervous system, she says. A medical event will also likely accompany other symptoms, like hot flashes, nausea, sudden sweating, shortness of breath, tremors, or heart palpitations, she adds. Impending doom may be a symptom of certain emergency medical conditions, including:

• Heart attack
• Aneurysm
• Seizure
• Anaphylaxis (a severe allergic reaction)
• Jellyfish sting (only certain types)
• Pulmonary emboli (clots that break off in the legs and flow to the lungs)
• Blood transfusion (reactions may cause a combination of anaphylaxis with hemolysis—the breakdown of red blood cells transfused)
• Anesthesia awareness (“waking up” during surgery)

Note that the likelihood of one’s feeling of impending doom being a symptom of any particular medical disorder lies hugely in that person’s other symptoms at the time, as well as in their own personal risk of specific medical illnesses, too.

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How to treat feelings of impending doom

Medical professionals will look to treat the underlying cause rather than the symptom itself. If the driver is anxiety, panic disorder, or depression, you may be treated with psychotherapy or medication. If the cause is physical, like a heart attack, and accompanies other related symptoms—chest discomfort, shortness of breath, nausea, breaking out in a cold sweat—call 911.

If you know that these feelings are related to anxiety, you can take control by taking a deep breath, holding it for three to five seconds, and then slowly exhaling, says Hafeez. “Repeat this while reminding yourself that everything is okay, and there is nothing to worry about,” she adds. A deep breath lowers your blood pressure and heart rate and shifts your nervous system from fight-or-flight to calm. Identifying triggers as well as participating in activities you enjoy for daily stress management can also be helpful.

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When to see a doctor

If you feel a sense of impending doom, are convinced something bad is going to happen, have a heavy, sinking feeling, and/or physical symptoms such as shakiness, sweating, or nausea, don’t hesitate to get help. Call 911 or your doctor. “If a patient walks in saying, ‘I feel like something bad is going to happen,’ doctors will take it very seriously,” says Hafeez.

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