The kanji composition literally combines 悲 (sadness) and 痛 (pain), indicating grief that is agonizing to experience or witness. Unlike general terms for sadness, this word specifically characterizes the external signs of deep anguish, frequently appearing in collocations like 悲痛な叫び (anguished scream) or 悲痛な面持ち (sorrowful expression).
Due to its gravity, it is rarely used for personal, everyday disappointments. Instead, it is typically found in literary contexts or news reports describing the emotional aftermath of accidents, disasters, and severe tragedies.