Sense of Impending Doom: What Does It Mean?

Everyone experiences it differently. It can be difficult to put into words. It could manifest as a similar feeling to a near-miss car accident when you think to yourself, “This is it,” and brace for impact.

For some, it may feel like an inner knowing or premonition that something awful is about to happen soon. For others, it may feel like something is “off,” and you fear that you’re about to die, even if not during a personal or medical crisis.

Research is scarce on this phenomenon, and much of the existing literature is older.

With a widespread symptom across multiple conditions, it’s difficult to find the common thread between them, though there are clues.

One explanation that 2019 research points to is the mind-body connection under stress.

The intense dread might be your body’s way of telling you that something isn’t quite right, either by a perceived threat in your mind (like anxiety) or a physical threat in the body (like a seizure).

We’re biologically wired for homeostasis, an internal sense of balance between systems. When something deviates from the norm, it trips a wire in your brain.

Once your brain sounds the alarm, also known as the limbic system, your fight, flight, or freeze mode becomes engaged, preparing you to face a threat.

That’s when your adrenal glands send a flood of hormones called catecholamines throughout your body, including adrenaline, producing uncomfortable side effects such as shaking and shallow breathing.

Research from 2019 shows that people who live with anxiety-related mental health conditions, like post-traumatic stress disorder (PTSD), may have an elevated stress response — meaning your brain generates a sense of doom even when your circumstances are not dire but are only mildly or moderately stressful.

Until researchers dig deeper into this, it’s difficult to know for sure why doom happens on a biological level, but it’s certainly a wake-up call.

An impending sense of doom is considered a symptom of an underlying condition, not a condition on its own.

To understand where the feeling is coming from, it’s best to work with a doctor or mental health professional. They can properly evaluate your symptoms and medical history to rule out different causes.

Though there is no definitive research, some believe this foreboding sense of calamity may be the subconscious cue for those with mental health conditions that they may be shifting to another episode within their condition.

Mental health conditions

• bipolar disorder
• depression
• generalized anxiety disorder (GAD)
• obsessive-compulsive disorder (OCD)
• panic attack
• post-traumatic stress disorder (PTSD)

Research shows evidence of physical issues that have been linked to an impending sense of doom.

Physical causes

• adverse reaction to a medication
• blood clot
• blood transfusion
• cardiac issues, like a heart attack
• COVID-19
• poisonings, like chemicals or a jellyfish sting
• seasickness
• seizure
• severe allergic reaction or anaphylactic shock
• tumor
• waking up during anesthesia

Along with intense fear that something bad is going to happen, you may also experience:

• breathing changes, like shortness of breath
• feeling disconnected from reality (depersonalization)
• increased heart rate or palpitations
• shakiness
• sweating
• temperature changes, like hot flashes
• upset stomach

You may be familiar with an impending sense of doom as a figure of speech or symptom of situational anxiety. This is more closely linked to stress or other mental health conditions than a medical emergency.

For example, you may feel an impending sense of doom before:

• having a hard conversation
• opening up your credit card statement
• passing through a storm on a plane
• taking the final exam in your class
• undergoing a medical procedure

In all of these examples, it may feel frightening and even create physical symptoms of a panic attack, but it’s not considered serious or life threatening.

If your sense of impending doom is related to a specific circumstance (like giving a speech), you may be able to manage it with deep breathing and self-care activities.

If your feeling is related to an ongoing mental health condition, such as anxiety or depression, you may find it helpful to work with a therapist and create a treatment plan.

If you don’t have a history of a mental health condition, but you experience fear and severe physical symptoms, this could be a medical emergency and require immediate attention. In this case, it’s best to err on the side of caution.

A sense of impending doom is a well-known, recognized medical symptom, not just a figure of speech (although it certainly can be that, too).

You may feel an overwhelming sense of dread from a specific trigger, or it can arise out of the blue. It may be accompanied by physical symptoms, such as a quickened heart rate, shallow breathing, or upset stomach.

With such a diverse range of underlying causes, working with a trained professional could rule out a severe medical condition and result in a correct diagnosis.

You know yourself best. If you don’t feel like “you,” trust your gut instinct. There’s no shame in getting the support you need to feel better.