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The dark cloud over your head that seems to be preparing to unleash a storm has a name: impending doom.
Call it what you want. The science fiction and fantasy worlds throw the concept of impending doom at heroes and audiences to give us stakes. They want us to know our characters are in danger, so when they escape unscathed, we’re all the more relieved.
Unfortunately, in our own brains, we don’t always know where the plot is going, so when we experience impending doom in our day to day lives, it can have a less literary impact: an overwhelming sense that death or danger is nearby and inevitable.
If you’ve experienced feelings of impending doom, you’re neither alone nor abnormal — most of us will have that experience once or more in our lives. But if feelings of impending doom have become a routine for you — if you’ve experienced impending doom in a pattern, with any frequency — you might have an issue affecting your mental health.
Dealing with recurring feelings of impending doom is important if they’ve begun to affect your quality of life, and luckily there are ways to get control over these sensations. But to have a chance at control, you first need to understand the origins of impending doom. Let’s start from the beginning: why do we feel impending doom in the first place?
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Impending doom doesn’t exactly feel like a healthy emotion, but in theory at least, it’s supposed to be a valuable survival mechanism.
For most people, impending doom is a characteristic of the feeling of anxiety and, in extreme cases, that anxiety is represented in the form of panic.
Panic is really just an element of our survival instinct, something that you might already know as the fight or flight response. Essentially, when our senses notice a threat nearby, our body’s stress hormone levels increase, and our brains attempt to determine how to protect ourselves: do we flee, fight, or freeze?
With anxiety, the fight or flight response can be engaged without a present threat, and importantly, it becomes unhealthy. Essentially, anxiety is the fear of an upcoming or hypothetical threat, and even if there is no threat, it can still cause your brain and body to stress, go into survival mode, and panic.
Impending doom is just a side effect of intense, uncontrollable anxiety. It’s anxiety dialed up all the way to the verge of hopelessness at the source of that impending doom.
Depending on the intensity of that feeling, you might be in the throes of an anxiety episode, or you might be experiencing the telltale sign of panic disorder: a panic attack.
Let’s say you are indeed having a panic attack — what does that feel like?
The telltale signs and physical symptoms of a panic attack include a multitude of things. You may experience heart palpitations, a pounding heart or increased heart rate, the sensation of having a heart attack, sweating, shaking, trembling, shortness of breath, and other forms of chest pain.
In essence, it may feel like you’re dying.
Not every panic attack looks the same, though, so you very well have had one and that sense of doom without labored breathing or dizziness.
Panic attacks can also account for a surprising amount of your time. You might have one extreme panic attack occasionally, or multiple anxiety attacks a day, depending on the form your panic disorder takes (and how many times a day your panic response is triggered).
Impending doom is just an element of it — a fear of bodily harm or death that is imminent or unpreventable.
Anxiety and impending doom are essentially cause and effect — if your anxiety is severe enough, a resulting symptom might be an intense fear that can make you experience a feeling of impending doom.
You can sort of look at this as a skill tree in a video game: at the top is your category: anxiety. You can specialize in a form of anxiety: panic disorder. What skills does panic disorder get you: fear of impending doom.
In other words, impending doom is one potential framework or customization of your individual anxiety disorder (or someone else’s, if you’re reading this in concern for someone else).
Impending doom may not be present in all people with anxiety, and not all people who have feelings of impending doom may necessarily have an anxiety disorder, but if you see a pattern of these feelings (or leave your anxiety untreated) it’s possible that the two could converge at some point.
What we’re getting at here is that the best way to deal with anxiety, impending doom, panic and anything else your brain is doing that does not spark joy is talk to a mental health professional about it. Let’s talk about what they might tell you when you seek treatment for anxiety.
As symptoms of anxiety go, a sense of doom may be one of the worst you can experience, but take comfort in one simple fact: the recommended treatment for anxiety is the same regardless of which symptoms you are or aren’t having.
That treatment for anxiety is actually a trio of anxiety treatment options: therapy, medication and lifestyle changes.
Anxiety can respond well to all three of these treatment types, and it can also be treated by a combination of one or more — or all three.
Therapy might take the form of cognitive behavioral therapy, which can help you push back against that sense of impending doom by learning ways to control those intrusive thoughts and modifying your patterns of thought with practice.
Medication, meanwhile, may simply be an antidepressant like a selective serotonin reuptake inhibitor: a medication designed to help your brain regulate the levels of a neurotransmitter chemical. Neurotransmitter management can reduce emotional extremes, which could help you reduce the intensity of panic attacks, or their frequency.
Finally, talk to a healthcare professional about habits, drug use, diet, exercise, drinking and stress. All of these things may be indicators for an increased risk of anxiety coming from somewhere in your life. These risk factors may be difficult to avoid in some cases, but all of them can be better managed, especially if your current management style is causing problems.
If you’re feeling hopeless at the idea of navigating treatment, narrow your focus and start small. You don’t need to cure anxiety or chug a bottle of antidepressants — in fact you shouldn’t do that last one ever. Instead, you just have to worry about your first step in this process: finding help.
A healthcare professional is your guide, best friend, back-up and reinforcement against any medical condition and mental illness, and they’ll be the ones to help you find the right treatment type for your individual needs.
If you’re not sure where to find one, consider our resources on what to look for in a therapy, the different types of therapy and if you’d like, check out our online therapy options. We offer immediate care with plenty of professionals to help you find the right personality fit.
It’s a great way to get hope in your corner before the next feeling of doom steps into the ring.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.