Sense of Impending Doom: What Does It Indicate?

What is a sense of impending doom?

When a person continually has a sense of impending doom, they might have a medical condition known as impending doom anxiety. Symptoms of this condition include constantly feeling like something awful is going to happen or that the world is coming to an end.

The constant impending doom feeling is often a sign of anxiety. Some other common symptoms of anxiety are:

• Feeling restless, nervous, or tense
• Having an increased heart rate
• Having a sense of impending danger or panic
• Hyperventilation
• Sweating
• Trembling
• Feeling tired and weak
• Difficulty concentrating on anything other than the worrying thoughts
• Difficulty sleeping
• Gastrointestinal problems 
• Having the urge to avoid things (such as places or people) that trigger anxiety
• Difficulty controlling worry

Panic attacks are frequent in people coping with an underlying anxiety disorder. Attacks can vary in length from a few minutes to hours. Some symptoms of panic attacks include palpitations, chest pain, presyncope (feeling like you’re going to faint), dyspnea (labored breathing), the fear that you’re dying, and a sense of impending doom. People with panic disorder get panic attacks often. Often, this results in feeling depressed and scared, worrying when the next panic attack will occur. 

Sometimes a person experiences feelings of impending doom when they have a heart attack. Additional symptoms of a heart attack include looking sickly and pale, sweating profusely, difficulty breathing, vomiting, and feeling nauseous. The symptoms of a heart attack can look different in different people, and the stereotypical signs of a heart attack are usually more applicable to men. As a result, heart attacks in women are often more overlooked. The common symptoms particularly of women experiencing a heart attack include trouble breathing, vomiting, and nausea.

What does the sense of impending doom feel like?

A sense of impending doom is a feeling of dread, terror, and worry that something terrible is going to happen; for example, that the world may end or that you may die. 

People dealing with fear and anxiety often experience strong feelings of dread and doom. These feelings can be especially intense when they occur for seemingly no reason. As these feelings seem to stem from no logical reason or threat, some people respond to them with fear, which makes the worry worse. The fear of impending doom is often described in some of the following terms:

• A feeling that something dangerous is about to occur
• A sense that something awful is about to happen
• An intense feeling of certainty that you’re about to die
• An intense feeling that something horrible is about to happen and that you won’t be able to do anything about it
• A strong sense of death and destruction that suddenly washes over you
• Intense fear of impending doom, despair, destruction, and gloom
• An overwhelming fear of impending doom that begins or occurs during a panic attack
• A horrible feeling of doom and gloom that suddenly comes over you
• Such an overwhelming sense of impending doom that you feel you must immediately escape to avoid something terrible happening to you 

This feeling of impending doom can occur suddenly, without apparent provocation, and can happen anywhere. 

The frequency of this feeling of impending doom can vary. It might come and go only very occasionally, occur frequently, or be a regular occurrence. 

The intense feeling of impending doom may come before, during, or after other anxiety symptoms or sensations, or it may occur on its own. The feeling can occur with feelings of anxiety, fear, nervousness, elevated stress, a panic attack, or an anxiety attack. Feelings of impending doom can also happen out of nowhere, for no obvious reason or threat. 

The intensity of the feeling of impending doom can range from slight to moderate or severe. It can also come in waves, feeling incredibly intense in one moment and becoming more mild the next. The feeling can change from moment to moment or from day to day. 

All of these variations of the feeling of impending doom are common. 

The reaction can be particularly strong when the feeling comes during a quiet, undistracted moment; for example, when a person is trying to sleep, when they are awakened by the feeling, or when they wake up in the morning.

What does a sense of impending doom indicate?

In some cases, a sense of doom may come before conditions such as:

• Heart attack 
• Stroke
• Seizure
• Anaphylaxis
• Cyanide poisoning
• Blood transfusion reactions

Anaphylaxis

Anaphylaxis is a severe allergic reaction that has a rapid onset and can be fatal. Some symptoms and signs of anaphylaxis include: 

• Skin reactions such as flushing of the skin, hives, and intense itching
• Respiratory reactions such as congestion, sneezing, tightness in the throat, runny nose, labored breathing, wheezing, and obstructed airflow
• Gastrointestinal reactions such as nausea, cramping, diarrhea, and vomiting
• Cardiovascular reactions such as chest pain, palpitations, low blood pressure, dizziness, and abnormal heart rhythm
• Other bodily and psychological responses such as anxiety, an impending feeling of doom, confusion, and lower back pain (sometimes due to uterine cramping)

Seizures

Focal seizures, also known as partial seizures, occur when abnormal electrical brain function occurs in one or more areas of one side of the brain. People with focal seizures, especially complex focal seizures, often report experiencing a premonition (or “aura”) before their seizure occurs. The most common feelings reported for these premonitions include impending doom, deja vu, fear, or euphoria. Additionally, some people experience changes in their hearing, vision, or sense of smell.

Poisonings

Although nutmeg is a common spice found in most households, it also has hallucinogenic properties. Medical literature over the last century has documented that less than one tablespoon can produce symptoms similar to those of an anticholinergic toxic episode and is known as acute nutmeg intoxication. Typical symptoms of an overdose of nutmeg include palpitations, hallucinations, and feelings of impending doom. 

Irukandji is a type of jellyfish commonly found in tropical Australia, the Caribbean, and the Indo-Pacific region. Stings from this jellyfish are a leading occupational safety and health issue for marine industries in these areas. A sting from the Irukandji jellyfish starts off relatively mild. However, the accompanying symptoms that often occur include debilitating illness, excruciating pain, nausea, sweating, vomiting, hypertension, a feeling of impending doom, and sometimes acute heart failure or pulmonary edema.

Ways to manage a sense of impending doom

Treatment for feelings of impending doom will depend on the root cause. 

If the sense of impending doom stems from an anxiety condition, stress management techniques, medication, psychotherapy, or a combination thereof may help. A therapist can help you learn how to cope with these feelings when they come on. 

For people experiencing a sense of impending doom due to anaphylaxis, heart attack, focal seizures, or poisoning, treatment of the underlying condition should help lessen the feeling. 

Speak to your health care provider if you’re experiencing feelings of impending doom. This feeling isn’t something to ignore and can indicate other health conditions that need to be addressed.

Things to remember

Never disregard a feeling of impending doom, especially if it’s happened more than once. A health care provider can help you understand the underlying cause and recommend a course of action. Understanding what this feeling means, particularly if it’s accompanied by other symptoms, can be lifesaving.