The album cover, shot by film director Gaspar Noé, portrays a topless Ferreira in a shower.

[5] The following month, she revealed that she was currently in the studio, working on her debut album with Jon Brion throughout 2012, and "possibly" with Shirley Manson and Greg Kurstin.

[6] In early 2012, Ferreira renamed the LP Wild at Heart,[7] and confirmed "24 Hours" and "Swamp Girl" would be included in it.

[9] After releasing the music video for the track "Red Lips" in June, she stated that she had renamed the record once again, changing its title to I'm Not Alright.

[12][13] After her single "Everything Is Embarrassing" unexpectedly became popular on indie-oriented music blogs, Ferreira released another EP, Ghost, on October 16, 2012.

[34] It depicts the close-up of a topless Ferreira, whose left breast is exposed and is wearing a cross necklace, inside of a green-tiled shower.

[35] She originally considered using another picture for the album artwork, and was additionally encouraged by Capitol Records to choose an older photograph where she was seen with "long blonde hair [...] sitting on a bed looking cute [...] in a black dress looking pretty".

[37] It was additionally made available for pre-order on CD and LP formats, although Ferreira publicly criticized Capitol Records when they were unavailable for its initial release and announced that she would self-fund the creation of vinyl versions.

[38] Following the launch of her third extended play, Night Time, My Time: B-Sides Part 1, in November, her MyPlayDirect store began selling bundles that included a green translucent vinyl pressing, a compact disc, a digital download, and a poster of the album artwork.

[43] Its music video, paying visual homage to 1983 film The Hunger and set in a high-fashion nightclub, was released on the same day.

[47] A music video for the album's title track, directed by Grant Singer and released on November 27, 2013, sees Ferreira wearing a variety of wigs and lingerie.

[48] Natasha Stagg of V wrote that, in the video, Ferreira "embraces the title she's been deemed by dressing in provocatively infantile accessories" and "cleverly [delivers] the junkie role back in her detractors' faces.

[51] Prior to the album release, US tour dates featuring Ferreira alongside Vampire Weekend and Smith Westerns were revealed.

[57] Writing for AllMusic, Heather Phares complimented the record for being "consistently good", and elaborated that Ferreira successfully blended "her teen pop past with her current interest in indie rock in surprising, creative, and always catchy ways".

[64] Kevin Leidel from Slant Magazine commented that the record had the potential of becoming the "gaunt, darkly painted neurosis" that would successfully "combat popular music's deluge of silly and crude self-affirmations.

"[27] Jordan Sargent from Spin enjoyed seeing Ferreira confidently and comfortably "reveling in the swirling cacophony that is her sound and her life.

"[29] Samuel Tolzmann from Pretty Much Amazing felt that the quality of the record dropped off from "Omanko" through the remainder of the album.

"[73] Pitchfork described the project as "blown-speaker, smeared-lipstick pop—would-be radio hits with that last topcoat of paint left incomplete", and acknowledged it as the 15th best record.

[37] In doing so, it became her highest-charting record in the country; by comparison, her second extended play Ghost (2012) reached number eight on the Billboard Heatseekers Albums chart.

It includes three previously unreleased tracks, in addition to the original version and the Unknown Mortal Orchestra remix of her earlier single "Everything Is Embarrassing" from her second extended play Ghost (2012).