In an interview with Complex Magazine, Scarface contextualizes “Diary of a Madman”:

Now that’s a good record. When I was about 20 years old, I had a fight with my girlfriend and I was really hurt about what had transpired. I did some things that hurt her that I shouldn’t have done and it never happened again in life but I felt so bad about it until I just went off in that fucking shell and hid. And that’s where that song came from. That was one of the deepest songs that I’ve ever written. It’s a guy that’s caught up with nothing to say to nobody but this book that he is confiding in.

I tried to kill myself so many times in life that I say it on that record. ‘I want to die but it ain’t for me/I tried to talk to my dad but my old man ignores me/He says I’m delirious/Plus I drink so he won’t take me serious/But little does he know I’m really losing it/I got a head with ain’t no screws in it.’ You know I got some bad motherfuckers man! That’s what I was going through at that time.

I tried [to commit suicide] at least four times. I got close enough where they wanted to put me in a hospital. The first time I tried I was about 13 or 14. I never understood the beauty of life until now. I never understood the beauty of life until I’d seen life take shape. Life takes shape and it’s mind blowing.