While the obvious connections with suicide or alcoholism could be drawn easily, more subtly this song could be about someone who views the world through a negative lens constantly and how as much as the writer tries to show the beauty in the world, this person refuses to see it. It's one or another between the rope and the bottle. There is no good option for this person. They can't see it. Skiba sings it in a kind of exasperated way like He's tired of hearing this negative view constantly and just allowing that person to continue feeling the way they feel knowing he can't do anything about it. You can hear it when he says maybe you're a vampire.
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