Sarah McLachlan describes this as being about "my problems in dealing with feeling responsible for everyone else." In a radio interview, she stated that it was inspired by the way her father always felt responsible for making sure everyone was happy.
Generally vague about the specific meaning, McLachlan did admit in an interview that one of several inspirations behind this song is her relationship with her best friend. Their relationship was rocky for a period of time after Sarah started seeing Ashwin Sood, whom she married in 1997 (they later divorced) and her best friend had dated in the past.
Adia is a female name meaning "God's Gift." McLachlan chose it simply because she liked the sound of it. Singers generally prefer names heavy on vowels.
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