Understanding and Managing Anguish: What You Need to Know

Anguish is an intense and complex emotional state caused by mental or physical suffering. When people experience anguish, they often feel extreme distress, sadness, torment, turmoil, and inner pain. While such feelings are often associated with losses or trauma, other overwhelming life challenges can also trigger this emotional state.

What Does Anguish Feel Like?

“Anguish can feel like angst and/or deep, complex suffering or sorrow, typically regarding something profound and valuable to us,” says Rainier Wells, LMHC, a partner provider at Grow Therapy.

Such feelings can manifest both physically and emotionally. Physically, this can create bodily sensations, including pain, soreness, heaviness, tearfulness, and slowed movement and momentum, Wells explains.

In addition to the physical experience of anguish, it can also result in examining aspects of identity, belief, and other existential questions.

Anguish vs. Anxiety

The terms anguish and anxiety share similar origins. Both derive from the Indo-European root “angh,” meaning tighten, strangle, or compress.1

While the two emotions share some similarities, including similar somatic experiences, anguish typically involves a more distressing experience.2 Anxiety centers on worry, fear, and apprehension, while anguish involves profound mental distress, sorrow, and despair.

Wells notes that anguish differs from sadness and anxiety in duration and intensity. “As anguish is often a response to grief, loss, trauma, tension, estrangement, and unexpected life situations, it often lingers for days, months, or more to varying degrees of intensity. Anguish can live alongside sadness and anxiety but tends to be more overwhelming and all-encompassing regarding a large life event,” they explain.

What Causes Us to Feel Anguish?

Anguish is a complex emotion that can have a variety of causes. Some factors that can contribute to this state include:

Grief and Loss

The death of a loved one can cause deep anguish, but the end of an important relationship or the loss of other important things in your life can also result in intense turmoil and despair.

Losing a meaningful attachment can create profound sadness, anger, and uncertainty. It can also lead people to experience changes in their identity and question their life’s purpose and meaning.3

Trauma

Natural disasters, accidents, violence, and other traumatic events can also lead to significant feelings of anguish. In addition to the initial disruption and distress that these events create, they can also lead to longer-lasting feelings of anxiety.

Other trauma symptoms include distressing memories, hyperarousal, hypervigilance, overwhelming emotions, emotional numbing, avoidance, guilt, and shame. Trauma can also interfere with a person’s feelings of trust and safety, which can heighten a person’s feelings of anguish and create a pervasive sense of anxiety and vulnerability.

Relationships

Relationships can be a source of connection, joy, and support, but they can also lead to pain and emotional suffering when they end or when they are marked by conflict. Breakups, infidelity, and discord can lead to feelings of anguish and emotional pain.

Illness

Physical pain and illness can be a source of anguish, particularly when it involves chronic conditions. People with chronic health conditions have a 50% higher risk of depression than those without such conditions.4

The long-term nature of such illnesses and their impact on a person’s quality of life can affect physical function and social connections. These effects can then harm a person’s self-worth and sense of empowerment in life.

Life Changes

While transitions are a common part of life, they can also bring feelings of fear and anxiety, particularly when people are faced with dealing with the unknown. Research has found that such periods can make people more prone to developing depression and other mental health problems.5

Major life changes, particularly involuntary ones, can create feelings of pain, uncertainty, and, in some cases, anguish. Divorce and job loss, for example, can interfere with a person’s sense of self, particularly if their identity was heavily wrapped up in their relationship or their job.

Loneliness

Social connections are crucial for good mental health, which is why loneliness can create anguish for people who feel cut off from meaningful relationships. Loneliness has a wide variety of health consequences, both physical and mental.

How Anguish Can Impact Our Lives

Anguish has powerful physiological and psychological effects. Such feelings are agonizing in the short term, but the stress they create can also contribute to long-term health problems.

“Living with anguish can result in disrupted sleep, poor or markedly increased appetite, difficulty concentrating, exhaustion, isolation, worry, and avoidance,” Wells says. “The event that the anguish is responsible for may be recalled through intrusive memories, thoughts, pictures, or emotional flashes.”

• Physical effects: The physical feelings of anguish can be overwhelming and even excruciating and can include racing heartbeat, chest pressure, sweating, trembling, muscle tension, nausea, and a feeling of being suffocated.
• Health problems: Anguish is an intensely stressful experience. If this becomes chronic, this stress can take a significant toll on a person’s physical well-being, putting them at a greater risk of illness and health problems.
• Reduced functioning: Experiencing anguish can make it difficult for people to function in their normal daily life. They may struggle to go to work or school, maintain social relationships, and perform daily household tasks.
• Cognitive effects: It is also common for people to have trouble concentrating and paying attention. This can contribute to poor decisions and difficulty remembering important information.
• Social effects: Anguish can be an isolating experience since it often leads to social withdrawal from friends, family, and other loved ones. People may experience feelings of shame about their emotional reactions or fear that others will not understand what they are going through. The pain they experience can also make it harder to maintain interpersonal relationships, which can reduce the social support that people need to help them get through these trying experiences.
• Mental health effects: Anguish can also contribute to other mental health problems, including anxiety and depression. People may begin to worry more or experience heightened fear and apprehension. Prolonged emotional suffering can also contribute to the onset of depression and symptoms such as changes in mood, loss of interest, and feelings of worthlessness.
• Suicide risk: The sheer intensity of anguish can heighten a person’s risk of self-harm or suicidal ideation. Some people may start to believe that suicide is the only way to escape their pain.
• How to Deal and Cope With Anguish

If you are experiencing anguish, it is important to get the help and support you need to help relieve your emotional suffering. Coping can be difficult, but there are strategies and resources available that can help.

Seek Help From a Professional

“It is important to monitor the impact on one’s life and seek out peer and professional support to work through processing emotions of anguish and the issue that brought on the emotion,” Wells says.

It can be helpful to talk to a mental health professional. A therapist can help you deal with the effects of emotional pain. You can also develop coping skills that can decrease distress and improve resilience.

Utilize Stress Relief Techniques

You can ease some heavy emotions you are feeling by limiting your exposure to stress and practicing effective relaxation techniques. Instead of pressuring yourself to return to normal, give yourself the space to process your feelings by setting boundaries or limiting your commitments.

Mindfulness, in particular, may help you better regulate your emotions and reduce the intensity of the anguish you are experiencing.7

Find Ways to Express Your Emotions

Anguish can become even more painful if you try to bottle up your emotions. While you might be tempted to hide your pain, suppressing or disguising your feeling can backfire, leading to problems with mental, social, and physical health.

It’s important to find healthy ways to process and express what you are feeling. This might involve talking about what you are feeling with a trusted friend, or creative endeavors like drawing, painting, music, movement, or journaling might provide a useful outlet.

Show Yourself Compassion

Don’t beat yourself up for what you are feeling. Negative thinking can turn anguish into feelings of guilt, shame, or embarrassment, so remember to treat yourself with the same kindness that you might show to a friend.

“Self-compassion involves compassion, common humanity, and mindfulness,” Wells says. They recommend working on skills such as self-acceptance, being present, connecting with others in non-judgmental ways, and successfully navigating emotions.

Instead, strive to treat yourself with kindness and give yourself the grace to work through your emotions without feeling overhwelmed.

Stay Physically Active

Exercise can be an important tool for mental health. While you might not feel motivated to work out when you are at your lowest point, research has shown that exercise can be an effective tool for relieving feelings depression and anxiety.8 It can also serve as a helpful distraction to help take your mind off of some of the stressors that are troubling you.

Seek Social Support

The support of friends and family can provide comfort and assurance when facing feelings of anguish. Emotional validation is essential when you are dealing with painful feelings and situations. Being able to share what you are experiencing and having those emotions recognized by others can reassure you that you are not alone.

Wells says finding ways to connect with others can also help build a sense of community and shared humanity. “Researching and joining your local grief, processing, or general peer support can provide a sense of inner compassion and empathy for oneself as you are held in a dignified and respectful way by others of similar experiences,” they explain.

Engage in Ritual

Wells suggests that rituals can play a key role in coping and healing.

Such rituals don’t need to be overly complex and should be personalized to your unique needs. “This could involve the simple lighting of a candle, journaling, attending a place that brings comfort, or finding a new routine to a difficult day. Draw from tradition and create your own,” Wells suggests.

Additional Resources on Anguish

Anguish can lead to feelings of fear, hopelessness, and anxiety that overwhelm our ability to cope. If you are dealing with emotional suffering, there are resources available that can help:

• National Suicide Prevention Lifeline: If you are experiencing thoughts of self-harm or suicide, call 988 anytime, day or night, to talk to a trained professional who can provide confidential support and direct you to other local resources that can help.
• SAMHSA Helpline: Call 1-800-662-HELP (4357) to speak with someone about mental health issues or substance use problems. They can direct you to resources in your area, including treatment facilities and support.
• LGBT National Hotline: Call 1-888-843-4564 to receive safe, confidential peer support and to talk about issues including sexuality, coming out, gender identity, relationships, self-harm, and bullying. The hotline is available Monday through Saturday.