The seventh studio album by Marilyn Manson, released worldwide on May 26, 2009 (a week after being released in Japan) was his last record released on Interscope. It marked the return of Twiggy (who dropped the moniker Ramirez to become a mononym). It was recorded during a break in the on-off tumultuous relationship that Manson had with Evan Rachel Wood:
I went through a tough period over Christmas, during which I learned the difference between love and dependence, and the difference between weakness and desire. And it made a big difference in my life. So I came back [to the studio] on January 2, and I saw my only friends, which at this point is the band, and everyone asked me, “How’re you doing?” And I said, “Well, I’m at the high end of low.” And automatically I knew that that’s what the record was going to be called.
The album was promoted as a return to the anger and aggression of Antichrist Superstar and described by Manson as:
very ruthless, very heavy, and very violent.
This record is the record we always wanted to make and [Twiggy] is writing from a point of view that I’ve always written from lyrically. I don’t think earlier on he had the opportunity to be damaged, and his soul to be trampled on by women as much as me. So now that his penis has been cut off metaphorically, and been smashed into fucking Sloppy Joe’s, someone shit on his heart a thousand times, we tried to put a musical face to that.