Breaking Benjamin began writing for Dear Agony during 2008. The recording process began in September, leading to its release one year later. The cover of the album is an MRI scan of frontman Benjamin Burnley's head. Burnley has cited Dear Agony as the first album he has written sober. After the album's release it entered the Billboard 200 Chart at #4 selling roughly 134,000 copies in its first week, slightly more than Phobia. It also topped the iTunes download charts in the first week of its release. As of February 16, 2010, "Dear Agony" has been certified Gold by the RIAA and sold over 700,000 copies. "Lights Out" was used to promote the game Halo: Reach.
On September 23, 2009, Breaking Benjamin released an online browser game constructed from Adobe Flash which is a parody of Altered Beast, aptly titled "Altered Benjamin". The game contains three levels and plays the same as the original, except the player controls vocalist Benjamin Burnley and the three bosses are each other member of the band respectively. The game also features the debut of the songs "Fade Away" and "Crawl".
Limited edition copies of Dear Agony purchased at Best Buy also included a bonus DVD that features the band's six music videos, including a previously unreleased version of the video for "I Will Not Bow". The version on the DVD is of the band only and does not contain any footage from the feature-film Surrogates, unlike the main version released online.
"I Will Not Bow" was released for sale on August 31 as the album's first single. It was released to the radio and the band's MySpace page on August 11, 2009 instead of the planned date, August 17, 2009 due to a leak by their hometown radio station, WBSX. This single is featured in the film Surrogates, with the music video containing scenes from the movie. On November 13, 2009, the official music video for "I Will Not Bow" was released on YouTube. This version, however, did not contain scenes from the movie Surrogates.
"Give Me a Sign" was released as a radio single on January 5, 2010. The music video was released on March 10, 2010 through the band's MySpace website and also on Vevo.
According to AOL Radio Blog and Rawkpit.com, "Lights Out" was announced as the third single and it went to radio on June 15, according to All Access.