At the height of her battle with Lyme disease, Avril Lavigne’s outlook was not good.

The singer, 34, said that she reached a point where she knew death was coming.

“I had accepted that I was dying,” Lavigne told Billboard magazine. “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,” which comes after a lengthy fight with Lyme disease that started in 2014, while she was on tour. Lavigne had noticed then that she lacked her usual energy, and went to doctors to try and figure out what was going on.

“I’m achy, I’m fatigued, I cannot get the f— out of bed — what the f— is wrong with me?” Lavigne said she asked doctors.

But it was a friend who pointed out that she might have Lyme disease, and another suggested she reach out to Yolanda Hadid — who also had Lyme — for advice. Hadid gave her the name of a specialist who could help.

Though she getting help, Lavigne said the disease sapped her of energy and she “was in bed for f—— two years.”

Lyme disease is unique in that it shifts and adapts to treatment, so there’s no easy treatment plan.

“It’s a bug — a spirochete — so you take these antibiotics, and they start killing it,” Lavigne said. “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—–.”

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Lavigne is still in treatment, but she’s regained most of her strength. She first opened up about the disease in 2015, during an interview with Good Morning America, and partially wishes she hadn’t.

“I don’t want to talk about it. I don’t want to relive it,” she said. “But it’s my responsibility.”

Lavigne feels that she needs to teach people about the dangers of Lyme disease, and started the Avril Lavigne Foundation to help people with serious illnesses and disabilities. And she is grateful that it gave her a forced hiatus from the music industry, and time to write her upcoming album.

“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 said. “This is the first break I’ve ever taken since I was 15.”

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