"I scream yet no one around seems to care about me"
These seem like contradictory lines, but I'm sure that's intentional. It almost gives the impression of someone who wants to be cared about and listened to, and no one cares or listens... and the person's reaction is to act tough and project an image of flippant, uncaring strength; yet deep down, they still have the sensitive need to be cared about that is still being unattended to. Hence the screaming.
I think there might be a little more to it...
consider
"I don't need no sympathy just a little honesty"
versus
"I scream yet no one around seems to care about me"
These seem like contradictory lines, but I'm sure that's intentional. It almost gives the impression of someone who wants to be cared about and listened to, and no one cares or listens... and the person's reaction is to act tough and project an image of flippant, uncaring strength; yet deep down, they still have the sensitive need to be cared about that is still being unattended to. Hence the screaming.