Feel Like You Are Going To Die

Causes

There are three main reasons why anxiety can make you feel like you are going to die:

• Behavior
• Stress response
• Hyperstimulation

1. Behavior

Anxious behavior, such as worry, is the most common cause of feeling like you are going to die.

While we can have strong physical and emotional moments, imagining something horrible will happen, often referred to as catastrophizing, such as you are about to die, is the most common reason for this symptom.

Overly anxious people often feel like they are going to die because of catastrophizing (imagining the worst) and the inability to contain anxious behavior.

2. The stress response

Anxious behavior, such as worry, activates the stress response, which secretes stress hormones into the bloodstream, where they travel to specific locations to immediately prepare the body for emergency action – to fight or flee. This instinctual survival reaction is often referred to as the Fight or Flight Response [1][2].

Visit the “Stress Response” article for the many ways it can affect the body.

Many of the stress response changes can make a person feel like they are about to die. For instance, the stress response:

• Quickly converts the body’s energy reserves into “fuel” (blood sugar) to instantly boost energy.
• Increases heart rate, respiration, and metabolism due to the boost in energy.
• Stimulates the sympathetic nervous system, increasing nervous system activity to be more sensitive and reactive to danger.
• Heightens most of the body’s senses to be more aware of danger.
• Increases activity in the amygdala (the brain’s fear center) and decreases activity in the pre-frontal cortex (the rationalization area of the brain) so that our attention is focused on the threat and away from thoughts that could be distracting.
• Shunts blood to parts of the body vital to survival, such as the brain, arms, legs, and vital organs, and away from parts less vital for survival, such as the stomach, digestive system, and skin.
• Suppresses digestion so that most of the body’s resources are available for emergency action.
• Creates a sudden urge to void the bowels in preparation to fight or flee.
• Tightens muscles to make the body more resilient to injury.
• Increases respiration to accommodate the increase in heart rate.
• Increases perspiration to keep the body cool and expel toxins.
• Increases a sense of urgency to take action to fight with or flee from the perceived threat.

Any combination of the above sudden changes can make it seem like you are about to die, especially when the amygdala becomes overly active, increasing a sense of danger and foreboding.

The higher the degree of the stress response, the more dramatic the changes. And the more anxious a person is, the more dramatic the stress response and feeling like you are going to die.

Anxiety and the accompanying stress response are common causes of feeling like you are going to die.

3. Hyperstimulation

When stress responses occur infrequently, the body recovers relatively quickly from its changes. However, frequently activated stress responses, such as from overly anxious behavior, can prevent the body from completely recovering. Incomplete recovery can leave the body in a state of semi-stress-response-readiness, which we call “stress-response hyperstimulation” since stress hormones are powerful stimulants.

Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation” [3][4].

Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.

Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated.

Just as an active stress response can cause acute danger and foreboding, hyperstimulation can cause a chronic feeling like you are going to die.

More specifically:

The brain’s fear center (amygdala and other areas) becomes more active and dominant [5].

This change can cause the fear center to become more aware of, sensitive to, and reactive to the notions of risk and danger.

In a sense, the fear center goes on hyper-alert, looking for and warning us of danger, and in more situations and circumstances than normal. As a result, the predominant tone of our thoughts and emotions is fear (danger, foreboding, impending doom).

As the degree of hyperstimulation increases, so can the feelings of danger and fear increase.

This is one of the reasons why smaller concerns can cause overdramatic responses when the body is hyperstimulated.

Furthermore, as stress increases, the stress response’s reactive nature increases. And, the more reactive the stress response, the easier it is to trigger another stress response (hyperstimulation can cause the stress response to become like a “hair trigger”—easy to fire).

Like how a military base goes on high alert when a threat is detected, hyperstimulation causes the amygdala to go on high alert. This increases the amygdala’s surveillance and readiness for threats. This elevated notion of danger also places the body on high alert (hyperarousal).

The amygdala and body only “stand down” when hyperstimulation is eliminated. Until then, the brain and body remain on “high alert” and ready for immediate action.

Stress, including anxiety-caused stress, suppresses the rationalization areas of the brain (the cortex and others) [5].

Consequently, hyperstimulation can dramatically reduce our ability to rationalize.

A reduced ability to rationalize can make it more difficult to dismiss irrational and fearful thinking, making it more challenging to calm ourselves down.

So, even though we may know that our thoughts and fears may be irrational, we’ll have a more difficult time dismissing them and keeping ourselves calm.

Hyperstimulation increases the electrical activity in parts of the brain [6].

An increase in electrical activity causes the brain to generate more thoughts, often referred to as “incessant mind chatter” and a “brain that never stops thinking.”

The combination of a heightened sense of danger and increased thought generation can make it seem like things are much more dangerous than usual.

An increased sense of danger can fuel catastrophizing, leading to the conclusion that you are about to die.

Hyperstimulation can cause the nervous system to act erratically [6].

An erratic-behaving nervous system (nervous system excitation and dysregulation) can cause episodes of intense distress and dread, often the cause of involuntary panic attacks.

As such, we can experience worrisome and distressing thoughts, emotions, and feelings at any time, to any degree, and about any situation, circumstance, subject, or topic.

Involuntarily caused episodes of distress and dread can seem to come from “out of the blue” and create a sense that you are dying.

When you combine overly anxious behavior with all of the physiological changes caused by stress and chronic stress, you have the perfect recipe for pervasive anxiety typical of this symptom.

4. Other Factors

Associated with anxiety, other factors can contribute to this symptom, including:

• Medication
• Recreational drugs
• Stimulants
• Sleep deprivation
• Fatigue
• Hyper and hypoventilation
• Low blood sugar
• Nutritional deficiencies
• Dehydration
• Hormone changes
• Pain

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