What does Psalm 38:10 mean?

Pouring out his heart to the Lord, David continues to describe his suffering under God's corrective discipline (Psalm 38:1–4). While some of these descriptors are poetic, David's pain is very real. He describes his heart with the Hebrew word sehar'har, which literally means something "passing through." In English, an equivalent figure of speech would be "my heart is pounding out of my chest." David's heart is "hammering" fiercely.

Guilt and shame over his sin (Psalm 38:18) have also stripped David of his strength. Here, he refers to weakness and blindness. Physical disease and injury can be natural consequences of sin. However, this psalm seems to be about David's spiritual, emotional response to the Lord's conviction (Psalm 38:8). That does not mean his response is entirely mental; the modern medical community notes the close correlation between emotional states and physical conditions (Proverbs 14:30). Depression, for example, can cause fatigue, weaken the immune system, constrict blood vessels, increase the risk of heart attack or stroke, negatively affect digestion, and contribute to high blood pressure and diabetes.

One advantage of leading a life of devotion to the Lord, in which sin is promptly confessed and forsaken, is the avoidance of these kinds of symptoms. Undoubtedly, a godly lifestyle spares a believer much grief and physical distress—at least by avoiding the natural outcomes of sin. It also keeps the believer from enduring conviction and discipline. Not all suffering is due to sin, of course. A vivid example of this fact is the apostle Paul. His health was not good, but those issues were not caused by sin. Persecution, trials, and a hectic schedule took its toll on his health (2 Corinthians 11:23–28).