The second studio album was meant to be primarily different and better than Count Your Blessings. Producer Fredrik Nordström was initially rarely present until he noticed the band's obvious musical progress. He then became more involved and by the end of the album was even enthusiastic about the result, which leaned more towards Metalcore.

The album cover features Stephanie Byrd, Oli’s then-girlfriend. The concept comes from an English idiom: to spill one’s guts, meaning to open up and reveal one’s secrets.

Suicide Season: Cut Up! is the remix edition of the album, on which BMTH collaborated with several other artists.