Avril Lavigne turned 34 today (September 27), and she’s celebrating a new year of life in stunningly poignant fashion: by dropping a video for her triumphant comeback single “Head Above Water.”

The emotional power ballad, released last week, is a metaphor for Lavigne’s near-death experience with Lyme disease, during which she’s said she felt like she was drowning. The Elliott Lester-directed video builds off of that imagery as Lavigne — looking ethereal in a flowing white gown — roams solo across mossy cliffs and black sand beaches (the video was shot on location in Iceland). At one point, the music cuts out entirely and you can only hear a heartbeat; at another, Lavigne plunges into the sea and sings for her life, pleading, “I’m too young to fall asleep.”

Lavigne previously said that “Head Above Water” came to her in a moment when she “had accepted that [she] was going to die,” which makes the birthday release that much sweeter. Accompanying the premiere is a charitable campaign from The Avril Lavigne Foundation, raising funds to provide treatment for people impacted by Lyme disease.

The release also comes a day after Lavigne’s debut performance of “Head Above Water” on Jimmy Kimmel Live!, which marked her first television appearance in years. Check out that similarly beautiful performance below.

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