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In my case, very sudden unexpected, all good one day happy no worries, next day severely sick feeling in pit of stomach, huge flight or fight overpowering feeling with no way to shed it, then got worse by the hour. I was unprepared for the immense physical impact, like being hit by a boulder.
Lost interest in everything (food, exercise, sex, hobbies, life) would shake uncontrollably.
By this time I knew I needed help.
It is an odd feeling, when you are confronted with your own mortality, every other thing falls away and shows itself as folly and inconsequential.
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