Health

Doctor explains phenomenon of people sensing their death days before it happens

David BenjaminOctober 13, 2025

The human body is capable of some amazing things. A broken leg can heal. Immune systems can fight off nasty bugs. Our brains create electricity so we can function. However, alongside all the mind-blowing stuff, it’s also capable of much darker things — one of which we’re here to shine a light on. ‘Impending doom’ is a death phenomenon whereby someone has a feeling that they are going to die soon — typically within a couple of days — and then it happens. While death isn’t always the end result (it can also be a type of delusion, or ‘emotional hallucination’: a false belief that is very strongly held and cannot be dissuaded), it can be a real occurrence, according to experts (Picture: Getty Images)

Metro spoke with Dr Deborah Lee of Dr Fox online pharmacy to unpack the phenomenon. ‘In medicine, if a patient has a sense of impending doom, this is regarded as a symptom in its own right,’ she states. ‘A person who feels impending doom will be extremely anxious, and you will be unable to change their mind that something dreadful — such as death — is about to happen.’ According to Dr Lee, doctors know that this is a serious symptom and that the patient may well be right, as they are likely to be experiencing sudden acute events. Here, Dr Lee shares how to recognise impending doom, what can cause it — both physical and psychological — and what to do if you think you are experiencing this symptom (Picture: Getty Images)

How to recognise a sense of impending doom

A person experiencing impending doom is likely to be anxious, agitated, restless and unable to settle. They feel an enormous sense of urgency that something bad will happen unless action is taken to stop it immediately. They are likely to seek medical help, even if they have no or few physical symptoms, as they are so convinced death is imminent. Sometimes, Dr Lee says they may feel a sense of depersonalisation, meaning that they are somehow detached from their body. Other physical manifestations may include palpitations, shortness of breath, sweating, hot flushes and tremors (Picture: Getty Images)

How to recognise a sense of impending doom

‘It’s very worrying as a doctor being presented with a patient who has a fear of impending doom,’ explains the doctor, as they are ‘likely to be having some kind of medical emergency.’ However, Dr Lee states that even the most serious conditions are treatable, and death is not necessarily inevitable — so long as the patient is seen and managed appropriately. ‘If this has a psychiatric cause, this is still serious and requires careful and prompt treatment,’ she adds (Picture: Getty Images)

Causes of impending doom

According to Dr Lee, various medical conditions are recognised to be associated with feelings of impending doom. In all these situations, the brain senses something is terribly wrong and translates this into a very frightening and unpleasant conviction that they are about to die. Here, the doctor has listed psychological and physical conditions (Picture: Getty Images)

Psychiatric conditions

For psychiatric conditions resulting in a sense of impending doom, Dr Lee explains: ‘The person feels anxious and unwell, but misinterprets the degree of danger.’ Whereas a rational person can try to adopt a positive approach, someone with a psychiatric condition cannot do this. ‘Instead, the opposite happens; they get more and more convinced something dreadful is going to happen, such as death, which further stimulates their anxiety, creating a vicious negative loop’ (Picture: Getty Images)

Psychiatric conditions which can contribute to ‘impending doom’:

• Panic attacks
• Bipolar disorder
• Depression
• Generalised anxiety disorder (GAD)
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder

(Picture: Getty Images)

Medical conditions:

Dr Lee has listed a string of medical conditions in which a person experiencing them can develop a sense of impending doom.

• Anaphylaxis: The huge release of histamine causes low blood pressure, hypoxia (low blood oxygen) and collapse (shock). Anaphylactic shock is frequently fatal, and the body is under no illusion of the seriousness of the condition.

• Blood transfusion reactions: The body’s immune system goes into overdrive, destroying the transfused red blood cells, causing an overwhelming inflammatory response and shock.

• Migraine with aura: This is a specific type of migraine headache, notes Dr Lee. The person experiencing it has premonitory symptoms known as an aura, which occur before the headache comes on. A scotoma may occur — this is loss of part of a visual field — sometimes seen as flickering light. Other symptoms can include weakness in an arm or leg, trouble speaking or loss of sensation in a part of the body. A fear of impending doom can also be part of the aura.

• Hypoglycaemia: This is the medical term for low blood glucose. If a person’s blood glucose levels suddenly fall (or are diabetic and have had too much insulin or not eaten enough), they will become confused, disorientated, and may feel a dreadful sense of impending doom. Dr Lee says that hypoglycaemia triggers the ‘fight, fright and flight’ system – the sympathetic nervous system (SNS) response to danger (Picture: Getty Images)

Medical conditions:

• Toxins and poisons: Toxins and poisons subject the body to things such as a sudden lack of ability to transport oxygen, or a toxin may paralyse a specific neurological function. Dr Lee says: ‘In response, this also triggers the fight, fright and flight system, and the body immediately pours out adrenaline and cortisol into the bloodstream.’

• Sepsis: ‘Overwhelming infection causes intense stress as the body grapples with the infection,’ says the doctor. There is extreme inflammation, reduced blood flow to the organs, and generalised hypoxia. The brain perceives the severity of the situation, causing confusion and an impending sense of doom.

• Phaeochromocytoma: This is a rare adrenal tumour that produces large amounts of catecholamines, and triggers the ‘fight, fright and flight’ system. This causes an acute, intense stress reaction.

• Intraoperative awareness: Rarely, a patient may partially regain consciousness during surgery if they are not given sufficient anaesthetic. This means they are paralysed so cannot move a muscle, but they can hear and feel what is happening. This can result in an overwhelming sense of dread (Picture: Getty Images)

Medical conditions:

• Pulmonary embolus (PE): A PE is a clot blocking blood flow to part of the lungs. Dr Lee says it usually happens suddenly, resulting in hypoxia (low blood oxygen level) and the sudden onset of breathlessness. Acute hypoxia causes confusion, fear and disorientation.

• Seizures: ‘A seizure often involves the amygdala, the part of the brain responsible for processing emotions.’ A patient might get the fear of impending doom before the seizure occurs. Dr Lee says this may be part of the aura — the premonitory symptoms that occur before the seizure starts.

• Heart attack: A heart attack occurs when the blood supply to the coronary arteries is blocked and the heart muscle is deprived of oxygen. Because it can happen very quickly, the body goes into shock, which causes low blood pressure. From here, the heart rate can become slower, faster, or abnormal. Or, it may stop altogether in a cardiac arrest. In these instances, the body perceives that something very serious is happening, which can lead to a sense of impending doom (Picture: Getty Images)

What to do about a sense of impending doom?

The NHS recognises impending doom as a serious symptom, and one that requires medical intervention. Therefore, if you have a sense of doom with other life-threatening symptoms, phone 999 or go to A&E. If you have the sense of impending doom, but your other symptoms are less troublesome, Dr Lee advises phoning NHS 111. Ultimately, she says that a sense of impending doom is a serious symptom which should not be ignored (Picture: Getty Images)

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