No one has truly hit the nail on the head with this song meaning
so ill try as best I can::
The singer is abviously extremely depressed
all he wants is someone to be there for him::
"wish someone would tell me I'm fine"

and how his life is so fucked up that hios last resort is, well, suicide::
"suffocation, no breathing, don't give a fuck if I cut my arm bleeding. This is my last resort.
i can't go on living this way"

and that absolutely nothing is going right::
"nothing's alright, nothing is fine, I'm runnin and I'm crying"

his depression has been eating at him for so long::
downward spiral, where do I begin? it all started when I lost my mother.
its saying I've been going through all this for so long, why should io have to deal with it any longer. (trust me, Jacoby, I feel your pain!)

this song truly has powerful and meaningful lyrics.
like it's definitely one of my favorite songs.