Verses 1-10
Psalm 6 Anxiety in a time of trouble
Through either illness or some other depressing situation, David is distressed, in both body and mind. This has caused him to search his life to see if God is using this affliction to punish him for some sin. Humbly he asks God for mercy (1-3). He fears death, and his pain and sorrow become more distressing through the personal attacks that his opponents make on him (4-7). The thought of these ungodly enemies, however, gives David confidence that God will heal him. He knows that God opposes the wicked but helps those who humbly seek him (8-10).
State of the dead
The Old Testament shows us that people do not cease to exist when they die, but it tells us little about the condition of life after death. The Hebrew word used for the unseen place and unknown state of the dead is sheol. Sheol was to the Israelites a place of darkness, silence and shadowy existence (Job 10:21-22; Psalms 39:13; Psalms 88:3; Psalms 88:10-12; Psalms 94:17; Psalms 115:17). Death was something unpleasant and fearful, on account of the mysterious existence that followed in sheol (Psalms 6:5; Psalms 31:17; Ecclesiastes 8:8). English Bibles have translated the Hebrew sheol by such words as 'the grave', 'the pit' and even 'hell'.
Certainly sheol would bring nothing but terror for the wicked (Deuteronomy 33:22; Psalms 16:10; Psalms 55:15; Isaiah 14:9-11; Ezekiel 32:18-32). The righteous, however, could expect that life after death would bring them joy in the presence of God (Psalms 16:11; Psalms 49:15; Psalms 73:24; cf. 2 Kings 2:11). But the name 'sheol' itself signified neither a hell of torment nor a heaven of happiness. It was simply 'the world of the dead' (GNB).
Death was the great leveller. Rich and poor, good and bad, oppressor and oppressed, kings and slaves were all subject to death. All died and went to sheol, the world of the dead (Job 3:13-19; Isaiah 14:19-20; Ezekiel 32:18-32). Sheol therefore became a synonym for death, and this is usually the way the word is used in Psalms.
By the end of the Old Testament era, believers were more fully convinced that beyond death lay the resurrection (Daniel 12:1-2). This confidence grew into bold assurance through Jesus Christ's death and resurrection. Christ conquered death and sheol (Matthew 16:18; Revelation 1:18; the Greek equivalent of sheol was hades), so that people no longer had any need to fear them (Hebrews 2:14-15). Through Jesus Christ, God clearly showed immortal life to be a certainty (2 Timothy 1:10).