Kesha wrote her new album, Gag Order, at the height of the pandemic. And in SELF’s June cover story, the singer explains why the project offers “a complete look at who I am.”

“With this album, it was the first time I shed real light on subjects that, previously, I was too nervous to,” she tells SELF. This is especially true of the song “Fine Line,” in which she sings, “All the doctors and lawyers cut the tongue out of my mouth.”

The reference to lawyers is obvious. Since she was 27, Kesha has been embroiled in an expensive, emotionally draining legal fight with her former producer, Dr. Luke. But the doctors mentioned in these lyrics speak to a completely different experience: Over the last year, the 36-year-old singer has been processing a weighty diagnosis, but she’s ready to talk about it now. In 2022, Kesha learned she has common variable immunodeficiency (CVID), a primary immunodeficiency disease that puts her at a high risk of developing recurrent, and potentially serious, infections.

CVID is pretty rare. It affects one in 25,000 to 50,000 people globally, and the condition is most commonly diagnosed in adults in their 20s and 30s. In addition to relentless infections, it can also lead to symptoms like breathing difficulties, GI problems, pain and swelling in the joints, and fatigue, among others. Experts don’t fully understand what, exactly, causes CVID to develop, but it has been linked to a mix of genetic abnormalities and environmental factors that impairs a person’s immune system from producing enough protective antibodies. In an estimated 25% of cases, including Kesha’s, CVID is associated with autoimmune issues, in which the immune system mistakenly attacks healthy parts of the body in an attempt to protect it.

Understandably, Kesha felt anxious about sharing this news publicly. “I just never wanted to be the whiny, privileged girl,” she says. “Also, my image had been that of going out and having fun.”

Eventually, she sought medical care when intense fatigue started to plague her daily. At first, she blamed it on her hectic schedule. “I had a really hard time saying no to interviews or photo shoots because I didn’t want to let my one chance fall away by not being able to fulfill every request,” she says. “It led to severe exhaustion physically and mentally.”

Earlier this year, she faced another health scare that was exacerbated by her condition. “I almost died in January,” Kesha tells SELF. Last year, she made the immense personal decision to freeze her eggs. “I just was taking my reproductive health into my own hands,” she says. “And I stand by everyone doing that and [honoring] your body.”

Weeks later, Kesha performed on New Year’s Eve in the Bahamas. Once the show wrapped, though, something felt off. She was too weak to walk and ultimately ended up in the hospital. Her doctors detected that she had experienced a rare, yet serious complication from the fertility procedure, due, in part, to her weakened immune system. She spent nine days in the hospital. “I finally feel recovered, but it took a couple months,” she says. “It was horrifying.”

Now, to preserve her physical and mental well-being, Kesha prioritizes rest, even when she’s on tour. “I learned after my diagnosis that sleep is the most important thing,” she says. “I feel like I’m just playing catch-up on my teens and twenties, still. But I try to get as much sleep as possible, and I have to protect that fiercely.”

Although CVID is a life-long condition, in many ways, Kesha is on a path of healing. She’s in recovery from her years-long eating disorder (a process that she says has been “so beautiful”), does EMDR therapy, and follows a pre-show tradition of meditating, stretching, and doing breathing exercises. “People probably think I’m back there doing shots,” she joked. “And [my routine is] the most zen shit you’ve ever seen.”

Read the rest of SELF’s interview with Kesha here.

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