Answer:
The introduction and the variables
It means that if you do not speak up about being depressed or "in pain" people around you that you interact with will unknowingly kill you on the inside and when/if you speak up they will assume you enjoyed it because you did not speak up before. Its a metaphor you see... if someone were to continuously stab you and you didnt speak up, they would stab you to death and assume you liked it for not acknowleding your pain. (excuse my terrible grammar im using an uncomfortable tablet with no auto correct and am trying to type this fast.)
