11 entries under cause great distress topic. ×

7
distressingly(adverb, painfully, unbearably, excruciatingly)
4
grievously
3
tragically
3
unfortunately
1
deplorably
1
distressfully
1
heartrendingly
1
lamentably
1
regrettably
1
tragical
1
woefully
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APASmart Define. (2015). heartbreakingly thesaurus. Retrieved October 1, 2026, from https://smartdefine.org/heartbreakingly/thesaurus/synonyms
ChicagoSmart Define. 2015. "heartbreakingly thesaurus" https://smartdefine.org/heartbreakingly/thesaurus/synonyms (accessed October 1, 2026).
HarvardSmart Define 2015, heartbreakingly thesaurus, Smart Define, viewed 1 October, 2026, <https://smartdefine.org/heartbreakingly/thesaurus/synonyms>.
MLASmart Define. "heartbreakingly thesaurus" 14 April 2015. Web. 1 October 2026. <https://smartdefine.org/heartbreakingly/thesaurus/synonyms>