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The title was inspired by Richard Farina's 1966 novel Been Down So Long It Looks Like Up To Me - Farina died in a motorcycle accident two days after it was published. The lyrical content was driven by the band's sense that they were constantly being harassed by authorities, notably Jim Morrison's various arrests.
Jim Morrison died shortly after this album was released. He did some of his best work on it, but still struggled with alcoholism and drug abuse. He went to Paris to relax, and died there under mysterious circumstances.
The phrase "been down so long, and it looks like up to me" was originally used by bluesman Furry Lewis in 1928.