Deep internal distress has the power to break a person's mental and spiritual strength, bringing them to a state of total confusion and deep fear for their very survival. The primary approach among commentators is that this internal collapse happens in two parallel stages, echoing the same profound pain throughout the entire self [רד״ק, אבן עזרא].
First, the inner spirit weakens, sinking into sadness and exhaustion [מאירי, מצודת דוד, ביאור שטיינזלץ]. The weight of anxiety causes a person's thoughts to fold inward, wrapping around one another in overwhelming distress [אבן עזרא]. Looking deeper, it is the feeling of a person nearing the very end of life, where all spiritual and mental energy seems to hide and completely slip away [מלבי״ם].
As the spirit collapses, the heart naturally reacts. Rather than fighting back, it shuts down. It is left blocked, silent, and completely stunned [רש״י, מצודת ציון, מאירי], overwhelmed by terror and panic [ביאור שטיינזלץ]. The heart, which normally drives a person's life force, stands lost and empty in the face of such hardship. Sensing that the end is near, it simply freezes in deep shock [מאירי, מלבי״ם].
A unique spiritual perspective reveals a complex relationship between the body and the soul during times of crisis and exile. Naturally, a pure soul sent from heaven should resent a flawed body that might drag it down to ruin. However, the suffering is so severe that the spirit actually chooses to grieve for and care about the physical body. Feeling the sorrow of this pure soul trapped inside with no way out, the heart is left entirely amazed and stunned [אלשיך].
Another layer connects this shock to the soul's journey at night. While a person sleeps, their spirit ascends to heaven, wrapping itself in bitterness and sorrow before God over the pains of exile. When the person wakes and the spirit returns to the body, the heart immediately absorbs the leftover traces of this heavenly grief, waking up completely overwhelmed and paralyzed by the lingering sadness [אלשיך].