A teenager asked me this difficult question. Much depends on the person suffering from anguish. Some people use this word freely, as if anguish somehow improved their status: that in itself is yet another form of anguish.
Anguish can also be having no hope in hope. Or conforming without resignation. Or refusing to confess even to oneself. Or never being oneself, should one ever know oneself. Anguish can be the misery of being alive. It can also be not having the courage to suffer anguish — and escape is yet another form of anguish. But anguish is part of life: all that lives, simply by being alive tends to recoil.
This same teenager asked me: Don’t you find there is a frightening emptiness in everything? Yes, there is. Meanwhile one waits for the heart to understand.