Loneliness runs through this poem like a low, steady hum. The speaker wants someone to talk to, a bit of guidance, and above all someone who will love them the way they love others. Instead they feel unseen. There's a sharp bitterness in the line about people who "had the guts" to ask them to share their insecurities, then seemingly didn't care about the answer.
The poem also shows how tiring it is to keep up appearances. The speaker feels that being themselves isn't enough, so they plaster on a smile and wear the right clothes, hoping acceptance and love will follow. Meanwhile the sleepless nights let anxiety and depression creep in, and the sarcastic "oh what a delight" covers real exhaustion.
The mood is raw, tired, and quietly painful. The drowning image says the speaker has been struggling for a long time, not just tonight. The last two lines hit hardest: in all that time, no one stopped to ask if they were alright.