This emoji goes beyond simple surprise (😮) to represent a deep shock mixed with mental anguish or despair. It can also express the feeling of helplessness when facing a difficult problem.

It's similar to the expression a character in a drama or movie makes upon learning an unbelievable truth. Among friends, it's used to show exaggerated surprise or to convey one's feelings about a truly serious worry. It carries a strong negative connotation.