Here's how it manifests in writing and speech:
In writing:
* Word choice: Words like "agonized," "desperate," "tortured," "heartbroken," or "wretched" are often used.
* Sentence structure: Sentences might be short and choppy, reflecting the speaker's emotional turmoil.
* Figurative language: Metaphors and similes might be used to convey the depth of the pain, such as "My heart feels like it's breaking."
In speech:
* Voice: The voice might be shaky, strained, or even a whisper.
* Pace: The speech may be slow and deliberate, or rapid and erratic.
* Body language: The speaker may have a hunched posture, clenched fists, or a pained expression.
Examples:
* "He cried out in anguish, his voice cracking with pain."
* "The news of her death left him in a state of anguished despair."
* "She stared at the painting with an anguished expression, unable to speak."
Essentially, an anguished tone evokes a strong sense of emotional turmoil and suffering.