The song was written by Ivan Moody about a female. In Arizona, when Five Finger Death Punch had a show, the female who Ivan Moody wrote "The Bleeding" about was at the show and it was the first time Ivan Moody saw her in about a year. Ivan Moody spoke about it saying
...when we performed in Arizona the girl who I wrote “The Bleeding” for was at the show and that the first time I had seen her in about a year and I almost broke into tears because it all came rushing back to me. I’m not one of those artists that just likes to get up on stage and drink beer, when I sing a song I like to take myself and the fans back to the place where I was when I wrote that song.
Ivan Moody spoke in an interview about the meaning of the song "The Bleeding" saying
That song is a two-part song and it comes across as a relationship piece, which it is. Half of it is about my ex-fiancé who meant everything to me, so once Motograter had fell apart and then her and I dwindled apart it just took a huge part of my life. So a lot of that song was about me losing that love and then having to say that it was over and move on. The other half was written about Motograter, because that was the closest thing I’ve ever had to a real family and it took a huge part of my soul.
A music video for the song, directed by Bradley Scott, was shot in Los Angeles on July 7–8, 2007. The video features actress Danielle Harris, and writer/director Sxv'leithan Essex, who also appeared in Five Finger Death Punch's video for the song "Never Enough", and directed the video for their song "The Way of the Fist". The video was released on July 27, 2007.
The video contains cuts of the band performing the song and a troubled couple portrayed by actress Danielle Harris and vocalist Ivan Moody. The video begins with vocalist Moody driving down an alley passing other members of the band and writer/director Sxv'leithan Essex and arriving at his house carrying in a box. As he enters the house he pulls pictures of him and Harris out of the box. It then flashes back to the couple sitting at a table with other members of the band drinking beer. Something happens and the couple begins to fight. After the fight it cuts to shots of Harris crying in the mirror and the couple having sex. It then shows Moody reading a letter and Harris taking a large amount of pills. At the end of the video Harris' feet are shown dangling, implying she had hung herself. The video ends with Moody taking an urn out of the box and spreading her ashes on the bed.
Ivan Moody commented on the video concept: "The video was a concept of mine. We were sitting around a table wondering how to project the visual for that song. One of our favorite songs of ours. I wanted it to be painful. Danielle Harris is the actress ... she was in The Last Boy Scout and the Halloween movies .. I sat down with her and racked her brain about it. It seemed logical to follow the lyrics and make it about what I went through relationship wise. The suicide part is just reality. There are situations out there that are hard to push through. I wanted that video to reconstruct how I felt when I was writing that song."
Album Version - This version of the song is included in every edition of The Way of the Fist album.
"Screamless" Version - This version of the song is available as a single on the iTunes library and contains none of the screaming from the album version. The song is shorter than the original because the scream near the beginning of the song was completely removed. Vocalist Moody recorded some new vocals for this version of the song, because some lyrics were screamed.
Acoustic Version - This version, known as "The Bleeding (Acoustic)" or "The Bleeding (Unplugged)" is a version of the song performed entirely on acoustic instruments. New vocals were recorded with no screaming, as well as new guitar, drum, and bass tracks. This version came with the band's debut EP, Pre-Emptive Strike and also with the re-release of The Way of the Fist.
Instrumental Version - This was released on bonus disk of the The Way of the Fist: Iron Fist Edition.