Pop-rock pioneer of the 2000s, Avril Lavigne has re-emerged after a five-year hiatus with a powerful worship song that reveals her cry to God after encountering a near-death experience.

While her new single was surprising on its own, the content has even more people turning their heads. It is a clear departure from the music Lavigne has produced in the past.

The song is titled “Head Above Water,” and details the struggles the singer has suffered through as a result of her battle with Lyme disease. Several lines of the song recount how she has had to fight against her own body to keep healing; otherwise, she would not have survived.

The disease caused Lavigne, now 33, to pause her successful music career for more than two years. She fought it with antibiotics and herbs for two years and stayed in bed the “majority of the time,” according to her website.

“One night, I thought I was dying, and I had accepted that I was going to die. My mom laid with me in bed and held me,” she said. “I felt like I was drowning. Under my breath, I prayed ‘God, please help to keep my head above the water.’ In that moment, the song writing of this album began. It was like I tapped into something. It was a very spiritual experience. Lyrics flooded through me from that point on.”

“God keep my head above water / Don’t let me drown / It gets harder / I’ll meet you there at the altar / As I fall down to my knees / Don’t let me drown / Don’t let me drown,” she sings in the song’s chorus.

Back in 2015, ABC News reported that the Canadian singer described her Lyme disease diagnosis as “the worst time of her life.”

“I feel bad because I haven’t been able to say anything to the fans to let them know why I’ve been absent. I’m torn as I’m quite private. … I’m not feeling well. I’m having some health issues. So please keep me in your prayers,” Lavigne told a fan on Twitter when her battle began.

Lavigne was “born into a devout Christian household and before her bad-girl image brought her mainstream success she sang in church choirs, local festivals, and county fairs.