Sometimes a single word carries a kind of weather inside it — rain, thunder, and silence all at once. For me, 'anguish' nails emotional struggle the best; it’s raw, immediate, and carries bodily weight. I reach for it when someone isn't just sad or unlucky, but their feelings are gnawing and active, a tightness in the chest that won’t untangle. In literature, 'anguish' shows up in moments that are more than plot — think about the interior storms in 'A Little Life' or a scene where grief reshapes a person.
On the other hand, words like 'ordeal' or 'adversity' point to external tests, almost procedural. 'Trauma' is precise and clinical; it’s necessary when you're signalling long-term psychological damage. 'Heartache' is gentler and perfect for personal loss or romantic pain. If I want readers to feel immediate, visceral suffering, I pick 'anguish'. If I want a softer ache, I use 'heartache'. Honestly, there’s a satisfaction in choosing the one that makes the scene breathe — 'anguish' does that for me.