it is definetly very cluttered, there is so much to take in and it doesn't make much sense. To me, it doesn't really represent madness, it's not really symbolic either. There is not much to interpret. The anatomy is ok and the face is very well done.
I tried to incorporate a few different ideas with one main reference (which I will not reveal myself) Some people have been able to get it and others just don't see it but that's just what art is all about. I can't really just tell people what this is about, I want them to figure it out, so I left a LOT of hits within this and each thing represents something. It is cluttered though, but that just makes it more fun to figure out. I could say to look at each piece individually, but everyone is allowed to look at it any way they want.
Thank you for your input I really do enjoy reading these.