A sense of total suffocation and absolute despair marks the peak of the psalmist's suffering. He feels entirely submerged by divine anger and terror, much like a person drowning in deep water. The imagery heavily focuses on being closed in from all sides. The primary approach among commentators notes a poetic repetition of being surrounded, serving to emphasize the sheer weight of the experience [רד״ק]. However, a deeper look reveals a terrifying progression. What begins as troubles merely circling nearby quickly worsens into a complete, airtight enclosure from every possible direction, leaving absolutely no way to escape [מלבי״ם].
The disasters are compared to massive, overwhelming waters threatening to pull the victim under [ביאור שטיינזלץ]. Just as water completely wraps around a sinking body, these hardships envelop him completely [מצודת דוד, אלשיך]. Taking this metaphor to a global scale, just as the oceans naturally wrap around the entire earth, God's fierce anger and terrors encompass the sufferer [רד״ק, מאירי].
This agony is not a brief, passing moment. It is a continuous reality, representing either endless, unbroken suffering or a prolonged period of sickness [אבן עזרא]. Making matters worse, these various anxieties, angers, and troubles do not arrive slowly or take turns. They strike all at once in a single, devastating blow [מלבי״ם, מצודת דוד, ביאור שטיינזלץ]. Living in this harsh, inescapable reality creates a complex psychological state. The sufferer has absorbed so much fear and trauma that it has actually become his second nature. The constant terror is no longer a shock; it has simply become his normal, everyday routine [אלשיך].