Spencer Chamberlain von der Band sagt über „Survivor's Guilt“ und seine lyrischen Themen und Ursprünge:
"I feel this heavy guilt about making it out alive when so many of my friends didn’t. There have been many times during my recovery when I’ve felt guilty, and that’s a mindfuck in itself, but it’s a real feeling. The opening line explains it pretty bluntly. I’ve been off drugs for 7 years, and I’ve lost 8 friends in 2023 alone to the same demon I was entangled with. It’s a heavy feeling to bear because it’s not like you’re better than anyone else out there—you literally just got lucky. I got my shit together before it was too late and I’m grateful for every single day I wake up now, especially because there was a time when I wasn’t sure I would.
The song was really fun to work on. The chorus came from the first idea I threw out there. I love when a song has such a powerful feel to the music that the vocals come out completely naturally. It made the sad heaviness feel even more intense. We’ve also never had a song with this type of swing to it, which is hard to pull off without it feeling cheesy, but I love the way this one hits. I could probably say this about every song on the record, but this is one of my favorite Underoath songs ever."