Vocalist and primary lyricist Shirley Manson had been struggling with writer's block, while recovering from throat surgery to remove a cyst on her vocal cords.

[1] Manson found herself inspired after attending a screening of coming-of-age movie Thirteen,[6] having shared similar experiences in her own teenage life.

[8] After regrouping in Los Angeles to work with John King on some songs at the beginning of 2004, Garbage were prepared to return to Madison to overcome the difficulties that had derailed the previous years sessions.

[1] "We came up with a whole slew of songs in the first week... Shirley wrote the lyrics to "Sex is Not the Enemy" and "Bleed Like Me"... suddenly words started pouring out of her. "

[9] He didn't get much response until Manson had developed lyrics for it, four vignettes about people she knew in her childhood and adult life, as well as an additional verse about J.T.

[12] The use of the vignettes as a lyrical device emphasised the point that Manson was making that "everybody has a story to tell"[6] but that it was important for people to remember that everybody else is carrying their own baggage too.

In the United Kingdom, "Bleed Like Me" was scheduled as the follow-up single to "Why Do You Love Me", and as such, promotional performances of the song were pre-recorded for Top of the Pops and CD:UK.

At the end of July, Garbage returned from touring European festivals to perform up and down North America's west coast.

Directed by Sophie Muller from a concept developed in collaboration with Manson, the music video for "Bleed Like Me" was filmed on April 11 at the disused Linda Vista Hospital in Boyle Heights, Los Angeles.

Manson chose graphic colours to make the visual image as powerful as the song's subject matter, being particularly delighted with the green tiled walls adorned with red crosses within the location.

[21] A sequence where Shirley's sleek chignon hairstyle is unpinned and grows out on-screen referenced a 1983 photo of musician Danielle Dax taken by Linda Rowell, a British rock photographer who documented the London goth scene of the time.

[29] Eric Kupper produced a club mix and dub version of "Bleed Like Me" which Geffen pressed to 12" vinyl and distributed to dance music DJs.

felt that "Bleed Like Me" "almost seems to be mocking [Manson's] own tendency towards self-obsession";[32] while their Emma Johnston, in a review for the album wrote that "Bleed Like Me" was the "most striking" song of the set, adding that it was "the most poignant, empathic reflection of self-abuse since Manic Street Preachers' "4st 7lb" – over a gorgeous cello strewn background, [Shirley shows her] battle scars, worn with pride, there to show that she survived".

[35] Isabel Mohan of Heat complimented Shirley's "seductive" voice as "better than ever"[36] (however two years later the same publication's Laila Hassan described "Bleed Like Me" as "a little tiresome and dreary" in a review of Absolute Garbage[37]).