Is a sense of dread a sign of something more serious?

Everyone experiences a form of dread or the feeling of impending doom from time to time, but if you can't pinpoint the reason for your unexplained feelings of dread, then there may be something more serious going on underneath the surface. Substance use and untreated medical or mental health conditions such as bipolar disorder or panic disorder may lead to feelings of dread in some cases, affecting both children and adults. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

It's important to identify these problems and seek out medical care from a qualified healthcare professional if you experience dread for seemingly no reason. This may help address underlying conditions and provide relief. Connecting with a supportive therapist online or through contact with support groups may help you treat the underlying root cause of your unexplained dread, refer you to additional resources, and involve family members in the recovery process. 

This article discusses potential causes of a sense of dread or a sinking feeling, including anxiety disorders and “panic attacks” associated with panic disorder. We’ll also discuss different methods you might use to find relief from these intense feelings. 

What is dread?

Many people (including children and teens) experience dread when they anticipate a negative event in the future. This emotion, which describes an intense fear, is a typical response in certain situations. For example, imagine you're at a restaurant and realize you left your wallet at home. You may dread getting the bill since you know you can't pay for your meal.

In most cases, this feeling is no cause for alarm. However, some people may experience dread even when they are safe and happy with no perceived threat. These individuals may be unable to pinpoint the cause of their dread or may find themselves dreading everyday situations, such as going to work or driving. If you experience dread, it is important to understand what is causing this feeling, as well as the risk factors and the role it plays in your life. Asking questions about your emotions can help determine the effectiveness of coping strategies and guide you toward understanding different types of support, depending on your state of mind and emotional states.

What is dread a sign of?

If you’re experiencing new or unexplained feelings of dread, your feelings may be related to an underlying medical or mental health disorder. Take note of when and how often you are having these feelings so you can tell if they are frequently appearing and so that you can discuss them with your doctor. You may also want to note any other accompanying physical symptoms, like nausea, shortness of breath, or a rapid heartbeat. Talking about your experience with a medical or mental health provider can help you get the treatment you need to feel like yourself again.

It can be helpful to review your history and consider any past occurrences that might cause a lingering sense of dread. For example, when a surgical patient experiences intraoperative awareness – awareness while under general anesthesia – that person may develop post-traumatic stress disorder, anxiety, or depression. If you speak with a mental health professional, bringing such events to their attention may help them develop a more effective treatment plan for your symptoms.

Medical conditions causing feelings of dread

Before and/or after certain medical procedures or events, you may experience a sense of dread. For instance, if you experience a heart attack, stroke, or seizure, you may be concerned this event will happen again, causing your feelings of dread. 

However, many medical providers consider a sense of impending doom to be a legitimate symptom of different medical conditions. For example, anaphylaxis, or severe allergic reactions, can cause some people to feel dread before other symptoms occur. So can seizures, heart attacks, and blood clots. Certain types of tumors, including brain tumors and tumors in the adrenal glands, may also cause you to feel dread.

• Generalized anxiety disorders: Anxiety disorders may also lead you to experience frequent feelings of dread, physical threat, or life-threatening danger. If you have been previously diagnosed with anxiety, discussing the root cause of your feelings of doom may help you manage this symptom. If you have not been diagnosed with anxiety but frequently experience dread along with other common anxiety symptoms like fatigue, unexplained body pain, or difficulty concentrating, you may want to discuss your symptoms with a mental health provider. A proper diagnosis of anxiety may help explain why you’re feeling the way you do. 

• Panic Disorder: Panic disorders are characterized by frequent panic attacks, which are episodes of intense anxiety or fear that may occur unexpectedly. People living with panic disorders may experience dread due to the unpredictable nature of panic attacks. Because panic attacks may also be accompanied by a sense of doom or despair, unexplained dread may be a result of an underlying panic disorder.

• Depression: Underlying depression may also cause unexplained feelings of dread. While many people may think of depression as being characterized by sad feelings, anxiety and dread are two other common symptoms of depression. If you have previously been diagnosed with depression, a mental health provider may be able to help you understand the relationship between your current symptoms and your history of depression. If you have not experienced depression previously, you may consider talking about your current symptoms with a medical or mental health care provider.

What does unexplained dread feel like?

For many people, dread may cause an intense sense that you are in danger. However, dread may be accompanied by other symptoms, including: 

• An unshakable feeling something bad is going to happen (to yourself, others, or the world) 

• Feeling fidgety or like you can’t sit still

• Nausea

• Sweating or hot flashes

• Generally not feeling well

• Uncontrollable shaking

• Chest pains

• Heart palpitations

If you notice you are feeling one or more of these symptoms, it’s important to seek immediate medical care. These symptoms may be a sign of a serious medical condition or an indication that you might experience a serious medical event, like a pulmonary embolism, seizure or stroke, soon. 

If you do decide to pursue support, your healthcare provider may run some tests to rule out certain medical conditions, such as blood clots. They may also discuss your personal life to help determine if you are experiencing anxiety, panic disorder, or some other mental health condition. If you have experienced any similar symptoms before or have been diagnosed with a medical or mental health condition, it’s vital to give as much information as possible to your healthcare provider to help you get the most effective treatment.

Treatment options for sense of dread

The treatment you receive for your dreadful feelings often depends on the underlying cause of your symptoms. In many cases, a physician or licensed counselor can help you create an effective plan for treatment. For example, people who are experiencing anxiety may be consulted about undergoing cognitive behavior therapy or taking medication (as prescribed by a doctor or psychiatrist), among other treatment options.

Getting support from a licensed counselor may also help people experiencing dread related to mental health challenges get the support they need to feel better. A mental health professional can support individuals in identifying why they’re feeling dread and work with them to overcome it.

Some lifestyle changes may also help you manage or prevent feelings of dread or anxiousness. In conjunction with targeted medical or mental health care, you may try the following to reduce negative feelings associated with dread:

• Paying attention to your physical health. If you know or suspect that you have a physical ailment, you may want to see a medical provider. Feelings of dread can be a warning sign for many serious conditions but avoid jumping to conclusions without consulting a doctor. 

• Paying attention to your mental health. If you’re experiencing feelings of sadness or anxiety, you may want to speak with a mental health provider, especially if these feelings affect your daily routine.

• Eating a balanced diet. Try to fill your plate with healthy foods and make sure that you are eating enough each day. A peer-reviewed study published in Missouri Medicine explains that eating healthy foods may improve mental health and promote healing.

• Finding a support system. Research confirms that strong social support can promote positive mental health outcomes. Having social relationships, friends, and families to lean on during periods you feel anxious or sad may support your mental and physical health. 

• Avoiding situations that exacerbate your symptoms. If you notice your feelings of dread arise in certain situations, such as in dangerous or stressful scenarios, try to avoid them whenever possible.

• Limiting stress when you can. Learn to recognize when you’re experiencing high levels of stress and do what you can to minimize it. Activities like yoga, meditation, or journaling may help, as can taking a break if you feel overwhelmed. 

• Exercising regularly. Exercise may help ease symptoms of depression or anxiety by releasing endorphins and replacing negative coping strategies with something more productive.

Speak with a mental health professional and try online therapy with BetterHelp

If you are experiencing feelings of dread without knowing the underlying cause, online therapy may help you feel supported. Since online therapy sessions can be performed after hours, online therapy is generally a more available form of mental health treatment for people who don’t already have an established mental health care provider. You can connect with a licensed therapist through BetterHelp, an online counseling platform. Speaking with a counselor online may feel more comfortable for those experiencing social anxiety, depression, or panic disorder, since therapy sessions may be obtained from a place the individual feels safe, like their home.

Your therapist may teach you problem-solving and relaxation methods to help reduce the feeling of dread you experience. 

The efficacy of online therapy for mental health conditions

Some individuals experiencing dreadful emotions have underlying mental health conditions like anxiety, panic disorder, and depression. In many cases, it’s important for them to seek treatment from a qualified, licensed professional. Online cognitive behavioral therapy is an evidence-based treatment method commonly used for treating these and other kinds of mental health disorders. One case report found that online-based CBT was effective in treating and managing various psychiatric disorders. Researchers also found that ICBT successfully managed comorbid mental health conditions resulting from physical conditions, such as depression in those living with diabetes.