The speaker talks about a kind of pain that stays hidden. Scars on the hip are physical marks of self-harm, and the poem suggests only two people know about them, and just one of those cares. That small count makes the speaker's world feel lonely. The scars are also permanent: "they're going to be there forever" sits in the poem like a quiet sentence with no way out.
Then the poem turns. The wrists are clear, so nobody would guess anything is wrong by looking. But the real struggle is in the speaker's head, where no one can see it. The final line, "constantly drowning," stands alone, and that isolation gives it weight. Drowning suggests being overwhelmed and unable to breathe, and "constantly" says it never lets up. The mood is raw, bleak, and tired. The spare lines and scattered layout feel like a person admitting something they rarely say out loud.