A purely \"heartbroken\" explanation doesn't make that much sense. We typically don't refer to feelings of loss or rejection with cutting except a heart being cut into pieces. However, the fact he continually repeats, \"gonna wind up dead,\" would indicate something more serious than hurt feelings.I think the song refers to a person slitting their wrists due to a bad breakup. Typically survivors of this type of suicide attempt will end up with stitches from the laceration. He also states, \"I'm left seeing red on my own,\" as a person committing suicide in this way would see a lot of blood and would do it alone. Furthermore, the phrase \"going under\" can refer to drowning or anesthesia, but in this context it would be \"going under the knife\". Also, \"begging you to come help,\" refers to suicide being a \"cry for help\".
I see it as someone who self harms or is suicidal. The line \"needle and the thread gotta get you outta my head, needle and the thread gonna wind up dead\" is representative of someone who had to get stitches after cutting too deep or attempting suicide, \"gotta get you outta my head\" shows that they are trying to get help and recover. 59ce067264