The Fall Out Boy album cover uses simplistic colors and imagery to disguise the hidden meanings and themes of madness within the album. The front cover features two characters - a bear and a person in a bear suit - positioned to represent the album's title "Folie a Deux" which refers to a rare psychiatric syndrome of shared psychosis. Throughout the album packaging, the use of colors, fonts, and mirrored/backward text reinforce themes of madness being portrayed or gradually taking over.