What to Do When You Are Dead is a concept album, with each song telling the story of the aftermath of the protagonist's suicide and his journey through the afterlife.

In February 2003, Armor for Sleep signed to independent label Equal Vision Records[1] who released the group's debut album Dream to Make Believe in June that year.

According to AllMusic biographer James Christopher Monger, the release gave the group "a solid spot" in the developing emo pop genre.

Decicco said that Machine felt that the bass needed to be recorded last because it goes out of tune quicker "so he has more of a reference to kind of hear things if he has them with the guitars already".

"[5] Around this time, Jorgensen was going through a break-up of his "first real relationship," combined with the two years of touring with the group "...It was a very transitional period, and all those emotions converged.

[7] According to Decicco, every song on the album is in Drop D tuning, often incorporating a ninth chord, which gave a "super rich" sound.

[4] AXS writer Terrance Pryor considers What to Do When You Are Dead a concept album centered around the protagonist's death and his subsequent journey in the afterlife.

Jorgensen later remarked that placing himself in that perspective helped him approach a number of situations he would have been afraid to tackle if he didn't pretend he was dead.

[5] The booklet features images of a man in a suit flying around and passing through walls, which, according to LAS Magazine writer David Spain, helps to immerse the listener by connecting the music and lyrics into the record's concept.

[14] In October 2004, Armor for Sleep toured with the Academy Is...[15] On November 3, 2004, What to Do When You Are Dead was announced for release in three months' time, and a rough mix of "Car Underwater" was made available for streaming through the band's PureVolume profile.

[22] Armor for Sleep performed on the West Coast and Midwestern dates of the Warped Tour in June and July 2005 after Midtown cancelled their appearances.

AllMusic reviewer John D. Luerssen wrote that the record "ups the punk/emo ante" with "fabulously" composed songs, as well as a yearning to tackle the "norms of a movement that has grown increasingly stale".

"[44] Raziq Rauf of Drowned in Sound wrote that the record had two "great" songs which could "fill the unashamed emo cynic with hope, only to be let down" by the remainder of the album.

[38] LAS Magazine writer David Spain called the album an "interesting notch along the battered branch of emo's legacy," with the band giving its contemporaries "food for thought".

[13] Spain noted that the group didn't simply intend on making "another 40-minute schmaltz fest; they vested thought and idea into their work".

[13] Ian M. Sands of The Boston Phoenix wrote that the majority of it comes across as the "well-worn hand-me-downs of a previous owner; all the same, it’s refreshing to hear an emo band breaking out of the formulaic".

[37] Melodic reviewer Andrew Ellis felt little had changed since the group's debut album, aside from the "more edgy guitars ... the songs [don't] grab me at all".

[39] While mentioning "Basement Ghost Singing" and "Car Underwater", Ellis said the "great tunes are too few" to make him give the album a higher rating.

[45] According to Now writer Jered Stuffco, Equal Vision was "banking heavily" on the band to accumulate strong sales, and based on the group's "poster-boy image, melodramatic harmonies and tight emo riffage," he felt they might succeed.

In 2015, Maria Sherman of Fuse.tv wrote that the album set the blueprint for "future pop-punk bands to explore concept records in very real ways".

[50] Calling it "impressive at the time, this band from the suburbs [wrote] a power pop-punk record with a linear, intricate narrative".

[50] AXS contributor Tarynn Law wrote that "the instantly relateable tracks that filled What To Do When You Are Dead soundtracked the teenage angst of kids all around the country for years to come".

[51] Brian Aberback of NorthJersey.com noted that the album placed the band on the "indie-rock map and continues to resonate heavily with fans 10 years later".