In moments of deep crisis and isolation, the most profound human need is to give voice to pain and distress. Turning to God during these times is not an attempt to provide Him with new information. Instead, it comes from a deep desire to pour out the heart, seek closeness, and ask for salvation. The act of speaking to God often involves recounting pains and hardships [מצודת ציון, ביאור שטיינזלץ], or simply engaging in general prayer [רד״ק]. This outpouring represents a vast sharing of troubles [מצודת דוד], as an abundance of prayer is naturally compared to a pouring out of the soul [מאירי]. There is also a precise order to this process. A person should first offer general prayers of praise to God, and only afterward present their personal needs and detail their specific hardships [תורה תמימה].
The setting of these events, taking place while David hides in a cave, adds another layer of meaning. In a dark and isolated place, a person cannot express their pain through body language or visible signs. Furthermore, there is no other human being around to hear the cry or offer help. Therefore, God becomes the only possible address for this pain [מלבי״ם]. Against this backdrop of hiding and concealment, there is a sharp contrast between the voice that is heard on the outside and the secret, internal pain held within the person [אבן עזרא].
During times of intense terror and fear, the very nature of prayer changes. In states of severe anxiety, a person is often unable to speak at length. Instead, they pour out their plea briefly and suddenly, much like turning over a barrel and emptying its contents all at once. Even so, God accepts this short, immediate cry as if it had been spoken with great length and detail. From another perspective, sometimes the hardship is so severe that there is no need to multiply pleas. Simply presenting the harsh reality is enough to awaken God's mercy [אלשיך].
This raises a natural question regarding why a person must declare their troubles before God when He already knows every hardship before a single word is spoken. Even though the distress is fully known to Him, a person must still speak about it because God actively desires the act of prayer itself [רד״ק, אלשיך]. Moreover, out of a deep sense of poverty and lack, a person understands that God stands right beside the destitute. Because of this, there is no need to shout for the prayer to travel great distances. The individual simply pours out their heart close by, speaking directly to God who is standing right beside them [אלשיך].