We’re talking about industrial-strength suffering here, both mental and physical. Thanks to what has been memorialized in Gospel accounts, most people associate this word with Christ’s Agony in the Garden. Agony doesn’t get more intense than that.
The word started out in Greek as agonia, a contest or struggle, and in some contexts it eventually meant to torture. As a noun, it referred to contests in ancient Greece, involving either athletic or musical competitions, in which prizes were awarded to the winners. To agonize in those days was to go all out in competition. Just do it.
As time went on, it was used to describe a conflict between characters in drama and in literature. The word entered English with the sense of mental suffering, then was extended to physical suffering. It is even used to describe the final battle -- the death agony.
Paradoxically, it has also been used in a positive and ecstatic sense, as when Alexander Pope spoke of “cries and agonies of wild delight” [Odyssey x. 492].
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