Pick up awful cheat, causing grief (9)
I believe the answer is:
heartache
'grief' is the definition.
(synonyms)
'pick up awful cheat' is the wordplay.
'pick up' becomes 'hear' (hearing is a kind of picking up).
'awful' is an anagram indicator.
'cheat' is an anagram of 'tache'.
'hear'+'tache'='HEARTACHE'
'causing' is the link.
(Other definitions for heartache that I've seen before include "Emotional anguish" , "Emotional distress" , "Grief" , "expression of sorrow" , "Great sadness" .)