You wake up, and before your feet even hit the floor, you’re hit with a feeling you can’t quite describe. Your heart thumps. Your chest feels tight. It’s not just normal morning dread. It’s a deep, heavy feeling that something awful is about to happen, a sense of impending doom. It can feel like the world is on the verge of collapsing and you’re the only one who knows. Your brain is stuck on red alert, but there’s no obvious danger. It’s a chilling, unsettling sensation that can be confusing, scary and even a little embarrassing to talk about. It’s not just a random bad mood. It’s a real and often intense feeling that deserves to be taken seriously. 

Your brain and body are trying to protect you, but the alarm can get stuck on loud, leaving you filled with dread. Let’s break down what may be going on, how the brain-body connection plays into it, what symptoms to watch for and how care from compassionate clinicians can help you feel steady again. 

6 possible causes of that gut-wrenching feeling of doom

That feeling of impending doom can show up for many different reasons. It’s not a condition on its own, but a symptom of something else going on. Here are some potential culprits behind it:

• Anxiety disorders and panic attacks

This can be a frequent culprit. A panic attack can come with a sudden, overwhelming feeling that something terrible is about to happen. This sense of impending doom is a core symptom of a panic attack. Even with general anxiety, you may have a constant, low-level feeling of dread that hangs over throughout the day. 

• Post-traumatic stress disorder (PTSD)

If you’ve been through a traumatic event, your brain’s alarm system can get stuck in the “on” position. This can lead to a state of constant high alert, where you feel like danger is always right around the corner. This lingering feeling of threat can manifest as a sense of impending doom. 

• Depression and bipolar disorder

In some cases, a feeling of impending doom can be part of a severe depressive episode. It can be tied to feelings of hopelessness and despair. For those with bipolar disorder, this intense dread can sometimes show up during episodes of depression or mixed states, where both depressive and manic symptoms are present at the same time. 

• Chronic stress

Living with high levels of stress for a long time can wear you down. Your brain is constantly releasing stress hormones, which can make you feel like you’re in a perpetual state of danger. This constant low-grade stress can create a background hum of worry that sometimes spikes into a more intense feeling of impending doom. 

• Situational or environmental triggers

Sometimes, the feeling can be tied to a specific life event, like a big exam, a major move or the loss of a loved one. The stress and uncertainty of these situations can be enough to trigger a feeling of dread. For example, the uncertainty surrounding a global crisis can be a source of a collective sense of impending doom. 

• Certain medical conditions

This is a serious potential cause, so don’t ignore it! A sudden sense of impending doom can be a symptom of a medical emergency. It’s a recognized sign of either a heart attack, anaphylaxis (a severe allergic reaction), and some neurological events like epileptic seizures and certain types of migraines. If this feeling comes on suddenly and intensely, and you have other physical symptoms like chest pain or difficulty breathing, you should seek immediate medical attention by calling 911.

The brain-body connection: Your internal alarm system

What makes your body react this way? It all comes back to a tiny but powerful part of your brain called the amygdala. The amygdala is like your personal bodyguard. Its main job is to process emotions like fear and help you recognize threats. When it senses danger, whether it’s real, like a bear, or imagined, like a missed deadline, it triggers your body’s fight-or-flight response. 

However, your brain can sometimes misinterpret situations. In a moment of high stress or during a panic attack, your amygdala may sound the alarm for a threat that isn’t actually there. It sends signals to your body to get ready for action, and that’s when you get the rush of physical symptoms and that scary feeling of impending doom. It’s your brain’s alarm system getting a little too excited and ringing at full volume when the danger is nonthreatening. This means your brain can shout “Danger!” during a normal Monday morning. 

The goal of care isn’t to shut off your alarm forever; that wouldn’t be safe. It’s to reset the sensitivity so it rings when appropriate, not at every small stressor. 

Symptoms that can come with that feeling

That sense of impending doom rarely travels alone. It often brings a whole crew of other symptoms with it. You may notice:

• A racing heart or palpitations
• Sweating or feeling like your hands are clammy
• Difficulty breathing or a feeling of a tight chest
• Racing thoughts that are hard to control or slow down
• A feeling of heightened sense of alertness, like you’re constantly looking over your shoulder
• An inability to shake the feeling, no matter what you do
• Avoidance of places, people or situations where you’ve had the feeling before
• Restlessness or irritability

These symptoms can feed off each other, creating a cycle that can feel impossible to break. That’s why getting professional support is so important.

When to seek help and when to call 911

Reach out soon if this feeling is frequent, interfering with sleep, school, work or relationships, or if you’re avoiding life to keep the dread away. Early help is easier help. 

Treat the feeling as an emergency and call 911 if the sense of doom is sudden and comes with:

• New chest pain or pressure
• Trouble breathing, wheezing or swelling of the lips and/or tongue
• Fainting or severe dizziness
• New neurological symptoms such as confusion, weakness on one side or seizures

Getting checked by a health care provider is never a wasted trip. 

How clinical care can help you gain control

If you’re dealing with these feelings, you don’t have to do it alone. Clinical care can provide the tools and support you need to understand what’s happening and regain control.

• Therapy

This is a powerful first step. Therapies like cognitive behavioral therapy (CBT) are incredibly effective. A therapist can help you identify the triggers for your feelings of doom and teach you practical coping skills. You’ll learn how to challenge negative thought patterns and ground yourself when you feel overwhelmed. 

• Medication management

Medication isn’t a magic cure, but a helping hand. For many people, medication can be a key part of their treatment plan, especially when symptoms are severe or get in the way of daily life. The right medication can help create a sense of calm and stability, making it easier to engage in therapy and practice new coping skills. Your psychiatric nurse practitioner may recommend a few different types of medication. Don’t lose heart if it takes some trial and error to find the right dose or medication.

ReKlame’s team provides culturally competent medication management, which is especially valuable for BIPOC and underserved members.

• Lifestyle changes

Small changes can make a big difference. Regular exercise, a balanced diet, getting enough quality sleep and practicing mindfulness can help reduce the frequency and intensity of these feelings. Your health care provider can help you to create a plan to incorporate these changes into your life. 

Take the next step toward balance with the help of ReKlame Health

We know how difficult it can be to find balance and feel in control of your life. That’s why at ReKlame Health, we’re committed to helping you take back control. Our team of diverse and compassionate clinicians offers culturally competent care that’s tailored to your unique needs.

We believe in providing support quickly, so we aim to get you in for a consultation within 48 hours of your first contact. Our care is based on proven, effective methods, including medication management and working with your other health care providers to ensure all of your needs are met. We are here to help, without judgment, every step of the way. 

Appointments are available within 48 hours. You’ve got this. Start by booking your first session today.