Avril Lavigne has described how she "accepted death" during her health battles.
The Canadian singer-songwriter first confirmed she had been diagnosed with Lyme disease, a bacterial infection spread to humans by infected ticks, in April 2015.
Since then, Avril has been open about her journey to get well again, though in a new interview with Billboard magazine she has shared how at her lowest point, she "knew death was coming".
"I had accepted that I was dying," she said. "And I felt in that moment like I was underwater and drowning, and I was trying to come up to gasp for air. And literally under my breath, I was like, 'God, help me keep my head above the water.'"
That moment inspired her new song, Head Above Water, her first single since 2015.
Avril began showing symptoms of Lyme disease in 2014 while she was on tour. Accordingly, she recalled to a reporter at the music publication the struggle she had with doctors to try and get an answer to her health woes.
"I'm achy, I'm fatigued, I cannot get the f**k out of bed - what the f**k is wrong with me?" she remembered of the questions she asked medical experts at the time.
But only after a friend suggested she get in touch with Lyme disease sufferer Yolanda Hadid - mother of models Gigi and Bella Hadid - was Avril able to get an insight into what was wrong.
While she's getting the help she needs, the star also explained that there is no easy treatment plan for the debilitating disease.
"It's a bug - a spirochete - so you take these antibiotics, and they start killing it," the 34-year-old stated. "But it's a smart bug: It morphs into a cystic form, so you have to take other antibiotics at the same time. It went undiagnosed for so long that I was kind of f**ked."
The Complicated hitmaker has now launched the Avril Lavigne Foundation in an effort to teach people about the dangers of Lyme disease, and to help people with serious illnesses and disabilities.
And she is strangely grateful that the disease gave her a forced hiatus from the music industry.
"The silver lining of it is that I've really had the time to be able to just be present, instead of being, like, a machine: studio, tour, studio, tour," she added. "This is the first break I've ever taken since I was 15."