Lyric discussion by RachiePie 

I think this song is just about someone who was an amazing person in the beginning, probably someone very close to Conor, who he basically had to watch ruin their life slowly. It's happened to me countless times. It's one of the most painful experiences in the world to watch a friend slowly fall apart and know there's nothing you can do about it, and I think that's what this song is about.

Also- Neely O'Hara is a substance abusing character from the Valley Of the Dolls, that's how she fits in. To my knowledge this song is not about bullemia, and the throwing up water I think it's probably not supposed to literally mean throwing up so much as just every day "throwing up" more and more of yourself, perhaps your soul. And Neely who he thanks and has brought on stage is a friend named Neely Jenkins but I do not think she is in any way related to this song.

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