This one and 'Are You Ten Years Ago' are so weird songs for me, like it's not Tegan and Sara stuff. There is a video of an in-store performance of this song, Sara messes up a few times, but doesn't give up. Model through it!
Someone pointed out, Sara's mentioned this song referring to problems with drug use & wanting to ask for help but struggling. Like, 'I really think I need help here, but I don't know how to ask, so I'm hoping you can figure it out/notice something is wrong, without me actually having to say anything.' I figured that "like O, like H" was simply an exclamation "OH" of sudden comprehension. Gut instinct, as it were.