Songfacts®:

• Marilyn Manson doesn't offer a lot of insight into his lyrics, but he posted on social media that "As Sick As The Secrets Within" is "a personal look into my life and I'm proud to be able to share my art and vision with you."
  
  The song's hook is:
  
  You're only as sick
  As the secrets within
  
  This evokes the phrase "You're only as sick as your secrets," which is often used in addiction recovery programs. Manson struggled with addiction for much of his life, which might be what he's addressing here.
• Released on August 2, 2024 as the first single from the album One Assassination Under God – Chapter 1, "As Sick As The Secrets Within" was the first new music from Marilyn Manson since his We Are Chaos album in 2020. In the interim, Manson was hit with a series of lawsuits from various women (including Evan Rachel Wood and Esmé Bianco) accusing him of abuse. Manson maintained his innocence but laid low as the cases worked their way through the courts. "As Sick As The Secrets Within" found him returning to action; the song doesn't make any direct references to his legal troubles, which is consistent with how Manson kept mum after stating his innocence in 2021.
  
  The summer before One Assassination Under God – Chapter 1 was released, Manson set out on tour with Five Finger Death Punch. In early 2025 prosecutors announced that they would not be filing charges against Manson, a big win for him.
• Manson wrote this song with Tyler Bates, who became his main creative collaborator on the group's 2015 album The Pale Emperor. Bates and Manson teamed to write all the songs on One Assassination Under God – Chapter 1, and it was recorded at Bates' studio: The Abattoir in Los Angeles.
  
  "These songs are really weighted with a lot of personal thoughts and emotions," Bates said on the Road To Rock Podcast. "The further you move through life, the more experience you have to draw from, and I think that's very apparent in this music."
• Bill Yukich directed the video, which finds Manson emerging from a chrysalis of some kind. There's also an octopus and lots of other striking imagery.
  
  Yukich's other videos for Manson include "Say10," "Tattooed In Reverse" and "Cry Little Sister." He's also made videos for Shinedown and Opeth.