Madeline Roth of MTV Canada named "Head Above Water" an "emotionally charged comeback". Murray described the song's lyrics and production in detail: "Now, we've never been 100% behind Avril Lavigne's music, but we can't help but be touched by the way she's approached what must be an enormously challenging situation." Writing for Spin, Anna Gaca described the track as a "dramatic piano ballad of resilience". Marina Pedrosa of Billboard wrote that "Head Above Water" "is a powerful, spiritual epiphany detailing the Canadian singer's journey through her battle with Lyme disease." Robin Murray of Clash complimented the track's production and deemed it a "highly personal note". The song was officially released on YouTube and worldwide streaming services on September 19, 2018. Lavigne shared a 30-second-snippet of the song on September 13, 2018. To help me see through the stormy weather. Praying to God for Him to help me just keep my head above the water. Like I was in a river being pulled in a current. Like I was going under water and I just needed to come up for air. I had accepted death and could feel my body shutting down. On September 6, Lavigne posted a lengthy letter to her fans on her website detailing her struggle in the past few years and how she overcame it, this also included a release date for "Head Above Water".
Several people reported that the image was related to the song "Head Above Water". On September 1, Lavigne shared a picture of her underwater via her social media. At the end of August, the song "Head Above Water" was registered and Lavigne deleted almost all her pictures on Instagram. On August 18, 2018, Lavigne posted on Instagram that new music is coming in September. After more than a year from the release of the last single from her fifth studio album, on December 25, 2016, Lavigne announced via her Instagram account that she was working on new music for her upcoming sixth studio album.
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