"Wish I could write songs about anything other than death," Julien Baker sings on Sprained Ankle's title track. It's true that the album is preoccupied with darkness (not only death but isolation, mental illness, and substance abuse), and when you realize that Baker is only nineteen years old, her intimate knowledge of suffering becomes even more harrowing. But there's also relief in the fact that she has overcome her past struggles successfully enough to speak on them so maturely and intelligently. Sprained Ankle is catharsis in its purest form: it hurts like hell, but it also heals, proving that sometimes the quickest way to cut through sorrow is simply to attack it head-on.

It would be easy to criticize the album for being musically unadventurous, as it doesn't veer far from the stripped-back presentation traditionally associated with singer-songwriter acts. But this would be to miss the point entirely: Baker's aim is not to impress with technical proficiency but to provoke with emotional potency, and too many bells and whistles would undermine this. Her quivering and unpolished but heartwrenchingly passionate vocals are rarely accompanied by anything more than reverb-heavy guitar, creating a cavernous atmosphere to match her soul-searching lyrics.

Bravely, opener "Blacktop" is the album's most vulnerable and bare moment, lullaby-esque with its hushed vocals and gentle guitar, though its lyrics suggest a brush with something far more fatal than sleep, with its references to ambulances and "a saline communion . . . held like a séance." It sets up the narrative pervading the entire album of the singer coming face-to-face with her own mortality and, consequently, being forced to rebuild her life from the ground up. Naturally, the fear of abandonment surfaces often, most palpably in the conclusion of "Everybody Does." Her voice so raspy with desperation that it makes even the listener's throat ache, Baker sings, "I know I'm a pile of filthy wreckage you will wish you'd never touched/You're gonna run when you find out who I am."

Meanwhile, "Rejoice" deals with the isolation caused by the guilt and anger felt upon surviving an addiction that has swallowed so many others whole. Although Baker admits that "I think there's a god and he hears either way when I rejoice and complain," she finds herself dissatisfied with religion's potential to provide comfort, going on to demand accusatively, "Why did you let them leave and then make me stay?" The catharsis reaches its peak in "Go Home" when Baker, sounding more weary and jaded than any teenager ever should, admits over sparse piano accompaniment, "I'm tired of washing my hands/God, I want to go home." This transitions into a staticky radio sermon that's cryptic and inconclusive, certainly, but, like the rest of the album, feels truest to life's constant uncertainty.