Albert Barnes Commentary Psalms 88:4

"I am reckoned with them that go down into the pit; I am as a man that hath no help," — Psalms 88:4 (ASV)

I am counted with them that go down into the pit—I am so near to death that I may be reckoned already as among the dead. It is so manifest to others that I must die—that my disease is mortal—that they already speak of me as dead.

The word “pit” here means the grave—the same as Sheol in the previous verse. It means properly:

1. A pit.
2. A cistern (Genesis 37:20).
3. A prison or dungeon (Isaiah 24:22).
4. The grave (Psalms 28:1; Psalms 30:4; Isaiah 38:18).

I am as a man that has no strength—who has no power to resist disease, no vigor of constitution remaining; who must die.