Bhu
2016-03-08, 02:34 AM
Been fiddling with a sanity system for a lovecraftian campaign set in 1776. All feedback is welcome. Please note I made some big mods recently so there may be typos I've missed.
Sanity Rules
Beginning Sanity All PC's start with a beginning Sanity equal to their lowest mental stat times 5. They take damage to this score from committing acts they find difficult to deal with, seeing things they were not meant to see, encountering things from other worlds, etc. Maximum possible Sanity is your highest mental stat times 5. Sanity is effectively the defense humanity has evolved against the things from Outside. Once it's gone, you can interact with them, and they can interact with you. Complete loss of Sanity is, in fact, a way of losing you're humanity and becoming more like the things from Outside.
Losing Sanity Whenever a PC encounters a difficult event, he or she must make a Willpower Save (DC is given below) or take the appropriate amount of Sanity loss. Once Sanity reaches 0, that character becomes incurably insane, and is retired from the game as they are effectively dead (or have joined the other side). Their mind is a shattered wreck and they are incapable of doing much of anything but scream, and fight. There is however a possibility they simply become an Outsider with the Native Subtype, particularly if they have the appropriate Knowledge skill, can cast spells, or have been exposed to Monsters quite a bit. Should a PC roll a Natural 1 on a Willpower Save to avoid Sanity damage, or take more than 20% of their current Sanity all at once (or within 1 hour), they will develop a temporary form of insanity detailed below.
If players are subject to Temporary Insanity have them roll a Willpower Save, DC 15. If they succeed Temporary Insanity lasts 1d10 Rounds, if they fail it's 1d10 Hours. If they roll a Natural 1, it's 1d10 Days. If during Temporary Insanity the PC loses up to 20% of their current Sanity again (or if they ever lose 20% of their maximum Sanity in one hour or less), their Insanity is permanent, rendering them incapable of functioning for (20 minus Wisdom Score weeks) and providing permanent symptoms thereafter (See insanities listed below). Sanity Loss for Monsters is listed in their description. For other events consult the chart below (Sanity damage listed before the slash is for a successful Save, damage listed after is for an unsuccessful Save):
Regaining Sanity
There are several ways to regain Sanity damage:
Defeating Things from Outside: If the PC's can defeat a monster they regain sanity equal to the maximum Sanity lost encountering one. Choose the monster doing the worst Sanity damage from the encounter, and the players receive Sanity equal to the max they would lose for a failed Willpower Save encountering the beast (for example if a Ghoul does 0/1d6 damage, and the PC's defeat/capture/murder the Ghoul, they can regain 6 Sanity). If the PC's can defeat a cult without encountering monsters they can regain 3 Sanity. If the PC's can put down the summoning of a God they regain 20 Sanity.
By increasing their mental stats: If the stat their Sanity is based on increases, so does their Sanity. For every permanent +1 to that mental stat they gain +5 Sanity.
Maxing out ranks in a skill: The first time a PC maxes out ranks in a particular skill, they gain 2d6 Sanity due to increased confidence. This can only be done once per skill.
Psychotherapy and Psychiatric medications are, alas, not available in this time period.
It is also possible to 'get used' to seeing monsters. Once the player has lost the maximum possible Sanity done by a particular monster (i.e. if it does 1d6 Sanity damage on a failed Willpower Save, and you've taken a total of 6 Sanity in one or multiple encounters) you stop losing Sanity against said monsters (some of the more powerful ones will still cause loss). One never gets used to seeing Gods or spellcasting (with the possible exception of Class Features).
Any instance in which you regain Sanity temporarily rids you of the symptoms of Temporary Insanity for 24 hours.
Event San Loss
Surprised to find mutilated animal carcass or a human corpse/body part (DC 13) 0/1d2
See a river flow with blood or other unexplainable phenomena (DC 14) 0/1d3
Find a mutilated human corpse, Perform an objectionable act (varies by persons beliefs, but would be things like hiding among corpses or mutilating a corpse) (DC 15) 0/1d4
Awake in a coffin, witness a friend's violent death, see a minor monster (DC 16) 0/1d6
Meet someone you know to be dead (DC 17), seeing most monsters 0/1d8
Undergo severe torture, Perform a very objectionable act (Forced to commit rape/incest/necrophagy/necrophilia, murder a friend, etc), See corpse rise from the grave or another event you know to be impossible, see powerful monster (DC 20) 0/1d10
See a gigantic alien head fall from the sky or other completely unexplainable alien event or witness the end of a civilization (DC 22), see very powerful monster 2/2d10
Confront a deity (DC equals 10 plus Deities Hit Dice plus Charisma Modifier i.e. you aren't making it) 1d10/1d100
Temporary Insanity Options
If the PC goes temporarily insane, choose whichever of the following is most appropriate:
Gains one of the following conditions: Confused, Cowering, Flat-Footed, Frightened, Sickened
Intense but temporary Phobia (see Phobia below, Base Save to approach object of phobia is DC 20, Penalty increases to -4)
If the PC rolled a Natural 1 on the Save, DM's may also choose from the following:
Gains one of the following conditions: Blinded, Nauseated, Paralyzed, Unconscious
Temporary Amnesia of the event due to repressed memory (which may call for another Willpower Save to avoid Temporary Insanity once the Amnesia wears off.
Temporarily gains any of the Insanities listed below.
Insanity
If the PC goes permanently insane they may suffer from one of the following disorders (Note: I do not believe in randomly rolling for insanities gained by an encounter. Pick one appropriate to the situation.):
Anorexia (http://en.wikipedia.org/wiki/Anorexia_nervosa): Each day the afflicted PC must make a DC 10 Willpower Save to eat normally. For each day he succeeds the Check takes cumulative -1 Penalty (meaning he will eventually fail). If the Willpower Save is failed he does not eat properly for the day. If the PC is damaged, suffering the effects of any negative status condition or harmful spell such as Bestow Curse, or under stress they take an additional Penalty to the Willpower Check of -1 (-2 if the problem has persisted more than 1 day). Once he has failed a Save and not eaten the Save DC resets to 10 + the number of times he has failed a Save. Once he has failed a Save three days in a row, he must make a Constitution check each day (DC 10, +1 for each previous check) or take 1d6 points of nonlethal damage and become Fatigued. Nonlethal damage from starvation cannot be recovered until the character gets food, as needed—not even magic that restores hit points heals this damage. Once his hit points fall to 50% of their maximum he is Exhausted instead of Fatigued. At 0 hp he becomes Staggered, at negative hp he becomes unconscious and if not fed within 24 hours must make a Fortitude Save each hour (DC 20) or die.
Cannibalistic Impulses (http://en.wikipedia.org/wiki/Cannibalism) aka Wendigo Psychosis (http://en.wikipedia.org/wiki/Wendigo): Each day the afflicted PC must make a DC 10 Willpower Save or feel compelled to eat human flesh. For each day he succeeds the Check takes cumulative -1 Penalty (meaning he will eventually fail). If the Willpower Save is failed he will attack someone if sufficiently provoked, and will begin to warn others he is a danger to them. He will be agitated, and aggressive, taking a -2 Penalty on all Charisma based skill checks other than Intimidation, and on Concentration Checks. If the PC is damaged, suffering the effects of any negative status condition or harmful spell such as Bestow Curse, or under stress they take an additional Penalty to the Willpower Check of -1 (-2 if the problem has persisted more than 1 day). After a second failure the PC will begin to stalk victims with the intent to murder and eat them, and will have to make a DC 20 Willpower Save to refrain from killing anyone they find themselves alone with. After a third failure the victim becomes incoherent and raving and will attack anyone he sees until he eats human flesh. After this point he will refuse to eat anything but his own kind, and will eventually starve unless force fed.
Delusional Disorder (http://en.wikipedia.org/wiki/Delusional_disorder): The PC has some sort of false belief involving circumstances that could come from real life. In short he might not believe electrical devices are powered by fairies, but he might believe they are harmful to be in the vicinity of. He might believe a common edible such as tomatoes are poisonous or unhealthy. This complicates his relationships with others and once someone else sees him display or discuss his false belief he suffers a -4 Penalty on all Charisma based Skill Checks against them (except possibly Intimidate). When determining NPC attitudes, if the PC fails the Check, the attitude of the NPC shifts two step towards hostile.
Dysthymia (http://en.wikipedia.org/wiki/Dysthymia): The PC has chronic depression, low energy, and lacks pleasure in most activities. This causes him to take a -4 Morale Penalty to all attack rolls, saving throws, and checks. When under severe stress such as being wounded, cursed, suffering a negative status condition, or other calamity he must make a DC 20 Willpower Save to avoid the Penalty increasing to -6 temporarily. If he succeeds in making the Save he must continue to make a Daily Save with the Save DC increasing by a cumulative +1 each day until the problem goes away or he fails. Once whatever is causing the increased depression is removed the PC gets a DC 20 Willpower Save to snap back out of it each day, and return to only having a -4 Penalty. Additionally when the Penalty is at the -6 level, the PC must make a DC 20 Willpower Save to allow himself to be convinced to perform any action that will require a Skill Check, Saving Throw, or Opposed Check of any kind. He gets a +1 to the Check per Ally who successfully makes a Diplomacy Check against him (perversely he also takes a -1 Penalty for every Ally who fails that Diplomacy Check).
Fetish: This is not the usual meaning ascribed to the term fetish. In this case the subject has an object without which they cannot rest or feel safe. If it is taken from them they will go mad with fear trying to get it back, and will likely agree to nearly anything to regain it's possession. Until it is returned they suffer a -4 on all rolls. If it is destroyed, or not returned within a week this will eventually convey symptoms similar to Post Traumatic Stress Disorder.
Generalized Anxiety Disorder (http://en.wikipedia.org/wiki/Generalized_anxiety_disorder):
The PC suffers from excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry. Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety. The PC suffers a -2 Penalty on all rolls due to this distraction. While under the effects of alcohol or caffeine this Penalty increases to -4.
Megalomania (http://en.wikipedia.org/wiki/Megalomania):
The PC has delusional fantasies of power, relevance, or omnipotence. Megalomania is characterized by an inflated sense of self-esteem and overestimation by persons of their powers and beliefs. It is more commonly in modern times referred to as Narcissistic Personality Disorder. In game terms, the character takes a -4 penalty on all Charisma based checks (except Intimidation). In addition, the attitudes of NPCs the character encounters are shifted in a negative direction. When determining NPC atitudes, the player must make an Opposed Bluff vs Sense Motive check for the character. On a failed check, the attitude of the NPC in question shifts one step toward hostile; on a successful check, the attitude is determined as normal. The PC also gains a +2 Bonus on Willpower Saves as they believe they are far more capable than they are, and as a consequence are somewhat fearless.
Nightmare Disorder (http://en.wikipedia.org/wiki/Nightmare_disorder): The PC suffers from frequent, horrifyingly violent nightmares. Each night as he goes to sleep the PC must make a DC 10 Willpower Save, which increases by +1 each day (meaning they will fail eventually). If they fail, their sleep is interrupted by nightmares and they gain no rest, and are Fatigued until they gain at least 8 hours sleep. Unfortunately, they now fear the nightmares and will do whats necessary to stay awake. A living creature can go without sleep for a number of days equal to its Constitution modifier (minimum one). Thereafter it is fatigued, remaining in this state for a number of days equal to its Constitution modifier (again, minimum one); if it would become Fatigued during that time, it is Exhausted instead. Each day after that period, the creature takes 1 point of Wisdom damage. Once Wisdom hits 0, the PC is out of the game until they can be forcefully put to sleep as they are now suffering from a particularly violent form of sleep deprivation induced psychosis and are effectively an NPC.
Pain Disorder (http://en.wikipedia.org/wiki/Pain_disorder): The PC suffers crippling pain caused by psychological stress. It generally begins with an injury or illness which takes a life of its own. The PC has a -4 penalty on attack rolls, skill checks, and ability checks.
Panic Disorder (http://en.wikipedia.org/wiki/Panic_disorder): The PC suffers from episodes of severe panic, and may usually have a linked phobia such as agoraphobia. The PC suffers a -1 Penalty on all rolls due to worry about attacks occurring. Anytime the PC is under stress, or has to confront something he fears, he must make a DC 20 Willpower Save or the Penalty increases to -4 for 1d6 minutes (4d6 minutes if they roll a Natural 1 on the Save). PC's under the influence of tobacco, alcohol, or caffeine take a -2 Penalty to this Save. PC's suffering from Panic Disorder also have a -2 on all rolls meant to avoid succumbing to addiction.
Paranoid Personality Disorder (http://en.wikipedia.org/wiki/Paranoid_personality_disorder): The PC has a pervasive and longstanding mistrust of others. This is not the same as Paranoid Scizophrenia, in which delusions are present or where the PC may have had a break from reality. The PC simply cannot bring himself to trust other people. In game terms, the character takes a -4 penalty on all Charisma based checks (-6 in the case of Gather Information, Intimidation Checks receive no penalty). In addition, the attitudes of NPCs the character encounters are shifted in a negative direction. When determining NPC attitudes, the player must make an Opposed Bluff vs Sense Motive check for the character. On a failed check, the attitude of the NPC in question shifts one step toward hostile; on a successful check, the attitude is determined as normal. People can sense the PC doesn't trust them, and therefore they see no reason to trust him in return. In addition the PC receives a -2 Penalty on all Sense Motive Checks, and automatically assumes the worst of someone on a failed Check.
Specific Phobia (http://en.wikipedia.org/wiki/Specific_phobia): The PC has an unreasonable or irrational fear related to exposure to specific objects or situations. As a result, the affected person tends to actively avoid direct contact with the objects or situations and, in severe cases, any mention or depiction of them. The fear can, in fact, be disabling to their daily lives. A DC 15 Will check is required for a character to be able to force herself into (or remain within) the presence of the object of her phobia, and even then the character takes a -2 Morale Penalty to all rolls as long as the object of fear remains. In severe cases, the object of the phobia is imagined to be omnipresent, perhaps hidden—thus, someone with severe acrophobia (fear of heights) might be frightened when in an enclosed room on the upper story of a building, even if there were no window or other way to see how high up the room was. The difference between this and Specific Phobia (Greater) is that the object of the Phobia is potentially avoidable. The subject of Specific Phobia (Greater) is either omnipresent, or cyclical and unavoidable (such as nightfall), and thus the penalty is effectively always on. Examples of Specific Phobia would be a specific animal or race or plant, heights, open places, a particular gender, stars, being alone, submerged places, books, thunder, empty rooms, snow, crowds, bridges, being touched, being alone, dead things, fire, etc. Examples of Specific Phobia (Greater) are darkness, light, water, wind, fear of being afraid, noise, pain, walking, or all animals, races, or plants.
Post Traumatic Stress Disorder (http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder): After enduring a horrible, traumatic experience such as war, the appearance of a monster, violent crime or other assault, the PC develops problems with anxiety, a loss of interest in life, possibly some paranoia, and nightmares and flashbacks inspired by the original event. This causes him to take a -2 Morale Penalty to all attack rolls, saving throws, and checks. When under severe stress such as being wounded, cursed, suffering a negative status condition, or other calamity he must make a DC 20 Willpower Save to avoid the Penalty increasing to -4 temporarily. If he succeeds in making the Save he must continue to make a Daily Save with the Save DC increasing by a cumulative +1 each day until the problem goes away or he fails. Once whatever is causing the increased depression is removed the PC gets a DC 20 Willpower Save to snap back out of it each day, and return to only having a -2 Penalty. Additionally when the Penalty is at the -4 level, the PC must make a DC 20 Willpower Save to allow himself to be convinced to perform any action that will require a Skill Check, Saving Throw, or Opposed Check of any kind. He gets a +1 to the Check per Ally who successfully makes a Diplomacy Check against him (perversely he also takes a -1 Penalty for every Ally who fails that Diplomacy Check).
Pyromania (http://en.wikipedia.org/wiki/Pyromania): The PC suffers from compulsions to start fires, either for self gratification or stress release. Setting fires gains them a distinct euphoria, intense enough that they will pursue it again in the future. Each day the PC must make a Willpower Save (DC 10) or start a fire. If successful, the Save DC increases by a cumulative +1 each day until the PC fails, at which time it resets. Please note that this does not need to be a large fire nor does it mean the PC is foolish enough to do so in front of others. If he fails the Save he will flee somewhere he can set a fire in solitude. For 24 hours after setting a fire, the Pyromaniac gains a +1 Morale Bonus on all rolls.
Some Pyromaniacs are instead drawn to fire. Whenever the afflicted PC sees a fire he must make a Willpower Save (DC 15) or be Fascinated by it. If successful, the Save DC increases by a cumulative +1 each day until the PC fails, at which time it resets.
Seasonal Affective Disorder (http://en.wikipedia.org/wiki/Seasonal_affective_disorder): The PC experiences a downward mood swing during either the summer or winter (although other patterns are not unknown). During this time of the year they experience difficulty waking up in the morning, morning sickness, tendency to oversleep and over eat, especially a craving for carbohydrates, which leads to weight gain. Other symptoms include a lack of energy, difficulty concentrating on or completing tasks, withdrawal from friends, family, and social activities, and decreased sex drive. All of this leads to depression, pessimistic feelings of hopelessness, and lack of pleasure which characterize a person suffering from this disorder. People who experience spring and summer depression show symptoms of classic depression including insomnia, anxiety, irritability, decreased appetite, weight loss, social withdrawal, and decreased sex drive. This causes him to take a -2 Morale Penalty to all attack rolls, saving throws, and checks. When under severe stress such as being wounded, cursed, suffering a negative status condition, or other calamity he must make a DC 20 Willpower Save to avoid the Penalty increasing to -4 temporarily. If he succeeds in making the Save he must continue to make a Daily Save with the Save DC increasing by a cumulative +1 each day until the problem goes away or he fails. Once whatever is causing the increased depression is removed the PC gets a DC 20 Willpower Save to snap back out of it each day, and return to only having a -2 Penalty. Additionally when the Penalty is at the -4 level, the PC must make a DC 20 Willpower Save to allow himself to be convinced to perform any action that will require a Skill Check, Saving Throw, or Opposed Check of any kind. He gets a +1 to the Check per Ally who successfully makes a Diplomacy Check against him (perversely he also takes a -1 Penalty for every Ally who fails that Diplomacy Check). Once the season passes the PC returns to 'normal'.
Social Anxiety Disorder (http://en.wikipedia.org/wiki/Social_anxiety_disorder): The PC suffers from severe anxiety in one or more social situations, or when being observed. Physical symptoms often accompanying social anxiety disorder include excessive blushing, excess sweating, trembling, palpitations and nausea. Stammering may be present, along with rapid speech. Panic attacks can also occur under intense fear and discomfort. Some sufferers may use alcohol or other drugs to reduce fears and inhibitions at social events. Without treatment this also likely leads to substance abuse and eating disorders as well. The PC must make a DC 20 Willpower Save to attend any social function or gathering with more than a handful of people. If they fail they will make any excuse necessary to not attend or leave as quickly as possible. When encountering circumstances that trigger this anxiety, this PC suffers a -2 Penalty on all rolls due to this distraction. While under the effects of caffeine or stimulants this Penalty increases to -4. PC's suffering from Social Anxiety Disorder also have a -2 on all rolls meant to avoid succumbing to addiction. Sufferers sometime also gain Anorexia (see above) or a similar eating disorder, or an addiction to drugs or alcohol.
Extremely powerful entities such as Gods or the most powerful monsters can cause minor strokes or other physical damage which may result in the following insanities (It should be noted these are not common and usually only result as permanent as opposed to temporary insanities):
Body Dysmorphic Disorder (http://en.wikipedia.org/wiki/Body_dysmorphic_disorder): The PC believes some physical aspect of themselves is flawed (or has an exaggerated sense of anxiety about one that is). In game terms, this is similar to Social Anxiety Disorder, with the addition that the PC undergoes extravagant lengths to hide their "flaw", sometimes leading to illness or self-harm. If their flaw is exposed and mocked, the PC will often fly into a Rage (as per the Barbarian Ability listed in the PHB) and blindly attack their insulter, as well as anyone within reach.
Obsessive-compulsive Disorder (http://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_disorder): The PC feels the need to check things repeatedly, perform certain routines repeatedly, or have certain thoughts repeatedly. People are unable to control either the thoughts or the activities. Common activities include hand washing, counting of things, and checking to see if a door is locked. Some may have difficulty throwing things out. These activities occur to such a degree that the PC's daily life is negatively affected. Often they take up more than an hour a day. In game terms this will work similarly to Panic Disorder, with the addition that the PC will also have to make a Willpower Save to avoid his penalty increase if he is prevented from performing his daily rituals as well as in stressful situation. If the penalty increase is triggered by a failure to perform a ritual, then successfully completing the ritual removes the additional penalty.
Psychopathy (http://en.wikipedia.org/wiki/Psychopathy): There is much disagreement and controversy over the use of this term. For purposes of the game this will refer to the theory of "Secondary Psychopathy", i.e. psychopathy created by a horrifically traumatic life. Secondary Psychopaths have definite problems with depression and anxiety, and a heightened sensitivity to fear. They are impulsive, and reactionary risk takers who seek out the forbidden. Unlike Primary Psychopaths they can feel guilt, shame and stress. But they do share their manipulative nature, cruelty, and lack of empathy. For game purposes this is similar to Dysthymia above, with the addition that the PC is a danger to others who may be prone to gambling, addiction or criminal behavior. Each day the PC must make a Willpower Save (DC 10) or engage in risky/criminal behavior. If successful, the Save DC increases by a cumulative +1 each day until the PC fails, at which time it resets. If he succeeds in his behavior without being caught he gains a +1 Morale Bonus on all rolls for 24 hours instead of his usual penalty..
Specific Phobia (Greater) (http://en.wikipedia.org/wiki/Specific_phobia): See Specific Phobia above.
Sanity Rules
Beginning Sanity All PC's start with a beginning Sanity equal to their lowest mental stat times 5. They take damage to this score from committing acts they find difficult to deal with, seeing things they were not meant to see, encountering things from other worlds, etc. Maximum possible Sanity is your highest mental stat times 5. Sanity is effectively the defense humanity has evolved against the things from Outside. Once it's gone, you can interact with them, and they can interact with you. Complete loss of Sanity is, in fact, a way of losing you're humanity and becoming more like the things from Outside.
Losing Sanity Whenever a PC encounters a difficult event, he or she must make a Willpower Save (DC is given below) or take the appropriate amount of Sanity loss. Once Sanity reaches 0, that character becomes incurably insane, and is retired from the game as they are effectively dead (or have joined the other side). Their mind is a shattered wreck and they are incapable of doing much of anything but scream, and fight. There is however a possibility they simply become an Outsider with the Native Subtype, particularly if they have the appropriate Knowledge skill, can cast spells, or have been exposed to Monsters quite a bit. Should a PC roll a Natural 1 on a Willpower Save to avoid Sanity damage, or take more than 20% of their current Sanity all at once (or within 1 hour), they will develop a temporary form of insanity detailed below.
If players are subject to Temporary Insanity have them roll a Willpower Save, DC 15. If they succeed Temporary Insanity lasts 1d10 Rounds, if they fail it's 1d10 Hours. If they roll a Natural 1, it's 1d10 Days. If during Temporary Insanity the PC loses up to 20% of their current Sanity again (or if they ever lose 20% of their maximum Sanity in one hour or less), their Insanity is permanent, rendering them incapable of functioning for (20 minus Wisdom Score weeks) and providing permanent symptoms thereafter (See insanities listed below). Sanity Loss for Monsters is listed in their description. For other events consult the chart below (Sanity damage listed before the slash is for a successful Save, damage listed after is for an unsuccessful Save):
Regaining Sanity
There are several ways to regain Sanity damage:
Defeating Things from Outside: If the PC's can defeat a monster they regain sanity equal to the maximum Sanity lost encountering one. Choose the monster doing the worst Sanity damage from the encounter, and the players receive Sanity equal to the max they would lose for a failed Willpower Save encountering the beast (for example if a Ghoul does 0/1d6 damage, and the PC's defeat/capture/murder the Ghoul, they can regain 6 Sanity). If the PC's can defeat a cult without encountering monsters they can regain 3 Sanity. If the PC's can put down the summoning of a God they regain 20 Sanity.
By increasing their mental stats: If the stat their Sanity is based on increases, so does their Sanity. For every permanent +1 to that mental stat they gain +5 Sanity.
Maxing out ranks in a skill: The first time a PC maxes out ranks in a particular skill, they gain 2d6 Sanity due to increased confidence. This can only be done once per skill.
Psychotherapy and Psychiatric medications are, alas, not available in this time period.
It is also possible to 'get used' to seeing monsters. Once the player has lost the maximum possible Sanity done by a particular monster (i.e. if it does 1d6 Sanity damage on a failed Willpower Save, and you've taken a total of 6 Sanity in one or multiple encounters) you stop losing Sanity against said monsters (some of the more powerful ones will still cause loss). One never gets used to seeing Gods or spellcasting (with the possible exception of Class Features).
Any instance in which you regain Sanity temporarily rids you of the symptoms of Temporary Insanity for 24 hours.
Event San Loss
Surprised to find mutilated animal carcass or a human corpse/body part (DC 13) 0/1d2
See a river flow with blood or other unexplainable phenomena (DC 14) 0/1d3
Find a mutilated human corpse, Perform an objectionable act (varies by persons beliefs, but would be things like hiding among corpses or mutilating a corpse) (DC 15) 0/1d4
Awake in a coffin, witness a friend's violent death, see a minor monster (DC 16) 0/1d6
Meet someone you know to be dead (DC 17), seeing most monsters 0/1d8
Undergo severe torture, Perform a very objectionable act (Forced to commit rape/incest/necrophagy/necrophilia, murder a friend, etc), See corpse rise from the grave or another event you know to be impossible, see powerful monster (DC 20) 0/1d10
See a gigantic alien head fall from the sky or other completely unexplainable alien event or witness the end of a civilization (DC 22), see very powerful monster 2/2d10
Confront a deity (DC equals 10 plus Deities Hit Dice plus Charisma Modifier i.e. you aren't making it) 1d10/1d100
Temporary Insanity Options
If the PC goes temporarily insane, choose whichever of the following is most appropriate:
Gains one of the following conditions: Confused, Cowering, Flat-Footed, Frightened, Sickened
Intense but temporary Phobia (see Phobia below, Base Save to approach object of phobia is DC 20, Penalty increases to -4)
If the PC rolled a Natural 1 on the Save, DM's may also choose from the following:
Gains one of the following conditions: Blinded, Nauseated, Paralyzed, Unconscious
Temporary Amnesia of the event due to repressed memory (which may call for another Willpower Save to avoid Temporary Insanity once the Amnesia wears off.
Temporarily gains any of the Insanities listed below.
Insanity
If the PC goes permanently insane they may suffer from one of the following disorders (Note: I do not believe in randomly rolling for insanities gained by an encounter. Pick one appropriate to the situation.):
Anorexia (http://en.wikipedia.org/wiki/Anorexia_nervosa): Each day the afflicted PC must make a DC 10 Willpower Save to eat normally. For each day he succeeds the Check takes cumulative -1 Penalty (meaning he will eventually fail). If the Willpower Save is failed he does not eat properly for the day. If the PC is damaged, suffering the effects of any negative status condition or harmful spell such as Bestow Curse, or under stress they take an additional Penalty to the Willpower Check of -1 (-2 if the problem has persisted more than 1 day). Once he has failed a Save and not eaten the Save DC resets to 10 + the number of times he has failed a Save. Once he has failed a Save three days in a row, he must make a Constitution check each day (DC 10, +1 for each previous check) or take 1d6 points of nonlethal damage and become Fatigued. Nonlethal damage from starvation cannot be recovered until the character gets food, as needed—not even magic that restores hit points heals this damage. Once his hit points fall to 50% of their maximum he is Exhausted instead of Fatigued. At 0 hp he becomes Staggered, at negative hp he becomes unconscious and if not fed within 24 hours must make a Fortitude Save each hour (DC 20) or die.
Cannibalistic Impulses (http://en.wikipedia.org/wiki/Cannibalism) aka Wendigo Psychosis (http://en.wikipedia.org/wiki/Wendigo): Each day the afflicted PC must make a DC 10 Willpower Save or feel compelled to eat human flesh. For each day he succeeds the Check takes cumulative -1 Penalty (meaning he will eventually fail). If the Willpower Save is failed he will attack someone if sufficiently provoked, and will begin to warn others he is a danger to them. He will be agitated, and aggressive, taking a -2 Penalty on all Charisma based skill checks other than Intimidation, and on Concentration Checks. If the PC is damaged, suffering the effects of any negative status condition or harmful spell such as Bestow Curse, or under stress they take an additional Penalty to the Willpower Check of -1 (-2 if the problem has persisted more than 1 day). After a second failure the PC will begin to stalk victims with the intent to murder and eat them, and will have to make a DC 20 Willpower Save to refrain from killing anyone they find themselves alone with. After a third failure the victim becomes incoherent and raving and will attack anyone he sees until he eats human flesh. After this point he will refuse to eat anything but his own kind, and will eventually starve unless force fed.
Delusional Disorder (http://en.wikipedia.org/wiki/Delusional_disorder): The PC has some sort of false belief involving circumstances that could come from real life. In short he might not believe electrical devices are powered by fairies, but he might believe they are harmful to be in the vicinity of. He might believe a common edible such as tomatoes are poisonous or unhealthy. This complicates his relationships with others and once someone else sees him display or discuss his false belief he suffers a -4 Penalty on all Charisma based Skill Checks against them (except possibly Intimidate). When determining NPC attitudes, if the PC fails the Check, the attitude of the NPC shifts two step towards hostile.
Dysthymia (http://en.wikipedia.org/wiki/Dysthymia): The PC has chronic depression, low energy, and lacks pleasure in most activities. This causes him to take a -4 Morale Penalty to all attack rolls, saving throws, and checks. When under severe stress such as being wounded, cursed, suffering a negative status condition, or other calamity he must make a DC 20 Willpower Save to avoid the Penalty increasing to -6 temporarily. If he succeeds in making the Save he must continue to make a Daily Save with the Save DC increasing by a cumulative +1 each day until the problem goes away or he fails. Once whatever is causing the increased depression is removed the PC gets a DC 20 Willpower Save to snap back out of it each day, and return to only having a -4 Penalty. Additionally when the Penalty is at the -6 level, the PC must make a DC 20 Willpower Save to allow himself to be convinced to perform any action that will require a Skill Check, Saving Throw, or Opposed Check of any kind. He gets a +1 to the Check per Ally who successfully makes a Diplomacy Check against him (perversely he also takes a -1 Penalty for every Ally who fails that Diplomacy Check).
Fetish: This is not the usual meaning ascribed to the term fetish. In this case the subject has an object without which they cannot rest or feel safe. If it is taken from them they will go mad with fear trying to get it back, and will likely agree to nearly anything to regain it's possession. Until it is returned they suffer a -4 on all rolls. If it is destroyed, or not returned within a week this will eventually convey symptoms similar to Post Traumatic Stress Disorder.
Generalized Anxiety Disorder (http://en.wikipedia.org/wiki/Generalized_anxiety_disorder):
The PC suffers from excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry. Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety. The PC suffers a -2 Penalty on all rolls due to this distraction. While under the effects of alcohol or caffeine this Penalty increases to -4.
Megalomania (http://en.wikipedia.org/wiki/Megalomania):
The PC has delusional fantasies of power, relevance, or omnipotence. Megalomania is characterized by an inflated sense of self-esteem and overestimation by persons of their powers and beliefs. It is more commonly in modern times referred to as Narcissistic Personality Disorder. In game terms, the character takes a -4 penalty on all Charisma based checks (except Intimidation). In addition, the attitudes of NPCs the character encounters are shifted in a negative direction. When determining NPC atitudes, the player must make an Opposed Bluff vs Sense Motive check for the character. On a failed check, the attitude of the NPC in question shifts one step toward hostile; on a successful check, the attitude is determined as normal. The PC also gains a +2 Bonus on Willpower Saves as they believe they are far more capable than they are, and as a consequence are somewhat fearless.
Nightmare Disorder (http://en.wikipedia.org/wiki/Nightmare_disorder): The PC suffers from frequent, horrifyingly violent nightmares. Each night as he goes to sleep the PC must make a DC 10 Willpower Save, which increases by +1 each day (meaning they will fail eventually). If they fail, their sleep is interrupted by nightmares and they gain no rest, and are Fatigued until they gain at least 8 hours sleep. Unfortunately, they now fear the nightmares and will do whats necessary to stay awake. A living creature can go without sleep for a number of days equal to its Constitution modifier (minimum one). Thereafter it is fatigued, remaining in this state for a number of days equal to its Constitution modifier (again, minimum one); if it would become Fatigued during that time, it is Exhausted instead. Each day after that period, the creature takes 1 point of Wisdom damage. Once Wisdom hits 0, the PC is out of the game until they can be forcefully put to sleep as they are now suffering from a particularly violent form of sleep deprivation induced psychosis and are effectively an NPC.
Pain Disorder (http://en.wikipedia.org/wiki/Pain_disorder): The PC suffers crippling pain caused by psychological stress. It generally begins with an injury or illness which takes a life of its own. The PC has a -4 penalty on attack rolls, skill checks, and ability checks.
Panic Disorder (http://en.wikipedia.org/wiki/Panic_disorder): The PC suffers from episodes of severe panic, and may usually have a linked phobia such as agoraphobia. The PC suffers a -1 Penalty on all rolls due to worry about attacks occurring. Anytime the PC is under stress, or has to confront something he fears, he must make a DC 20 Willpower Save or the Penalty increases to -4 for 1d6 minutes (4d6 minutes if they roll a Natural 1 on the Save). PC's under the influence of tobacco, alcohol, or caffeine take a -2 Penalty to this Save. PC's suffering from Panic Disorder also have a -2 on all rolls meant to avoid succumbing to addiction.
Paranoid Personality Disorder (http://en.wikipedia.org/wiki/Paranoid_personality_disorder): The PC has a pervasive and longstanding mistrust of others. This is not the same as Paranoid Scizophrenia, in which delusions are present or where the PC may have had a break from reality. The PC simply cannot bring himself to trust other people. In game terms, the character takes a -4 penalty on all Charisma based checks (-6 in the case of Gather Information, Intimidation Checks receive no penalty). In addition, the attitudes of NPCs the character encounters are shifted in a negative direction. When determining NPC attitudes, the player must make an Opposed Bluff vs Sense Motive check for the character. On a failed check, the attitude of the NPC in question shifts one step toward hostile; on a successful check, the attitude is determined as normal. People can sense the PC doesn't trust them, and therefore they see no reason to trust him in return. In addition the PC receives a -2 Penalty on all Sense Motive Checks, and automatically assumes the worst of someone on a failed Check.
Specific Phobia (http://en.wikipedia.org/wiki/Specific_phobia): The PC has an unreasonable or irrational fear related to exposure to specific objects or situations. As a result, the affected person tends to actively avoid direct contact with the objects or situations and, in severe cases, any mention or depiction of them. The fear can, in fact, be disabling to their daily lives. A DC 15 Will check is required for a character to be able to force herself into (or remain within) the presence of the object of her phobia, and even then the character takes a -2 Morale Penalty to all rolls as long as the object of fear remains. In severe cases, the object of the phobia is imagined to be omnipresent, perhaps hidden—thus, someone with severe acrophobia (fear of heights) might be frightened when in an enclosed room on the upper story of a building, even if there were no window or other way to see how high up the room was. The difference between this and Specific Phobia (Greater) is that the object of the Phobia is potentially avoidable. The subject of Specific Phobia (Greater) is either omnipresent, or cyclical and unavoidable (such as nightfall), and thus the penalty is effectively always on. Examples of Specific Phobia would be a specific animal or race or plant, heights, open places, a particular gender, stars, being alone, submerged places, books, thunder, empty rooms, snow, crowds, bridges, being touched, being alone, dead things, fire, etc. Examples of Specific Phobia (Greater) are darkness, light, water, wind, fear of being afraid, noise, pain, walking, or all animals, races, or plants.
Post Traumatic Stress Disorder (http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder): After enduring a horrible, traumatic experience such as war, the appearance of a monster, violent crime or other assault, the PC develops problems with anxiety, a loss of interest in life, possibly some paranoia, and nightmares and flashbacks inspired by the original event. This causes him to take a -2 Morale Penalty to all attack rolls, saving throws, and checks. When under severe stress such as being wounded, cursed, suffering a negative status condition, or other calamity he must make a DC 20 Willpower Save to avoid the Penalty increasing to -4 temporarily. If he succeeds in making the Save he must continue to make a Daily Save with the Save DC increasing by a cumulative +1 each day until the problem goes away or he fails. Once whatever is causing the increased depression is removed the PC gets a DC 20 Willpower Save to snap back out of it each day, and return to only having a -2 Penalty. Additionally when the Penalty is at the -4 level, the PC must make a DC 20 Willpower Save to allow himself to be convinced to perform any action that will require a Skill Check, Saving Throw, or Opposed Check of any kind. He gets a +1 to the Check per Ally who successfully makes a Diplomacy Check against him (perversely he also takes a -1 Penalty for every Ally who fails that Diplomacy Check).
Pyromania (http://en.wikipedia.org/wiki/Pyromania): The PC suffers from compulsions to start fires, either for self gratification or stress release. Setting fires gains them a distinct euphoria, intense enough that they will pursue it again in the future. Each day the PC must make a Willpower Save (DC 10) or start a fire. If successful, the Save DC increases by a cumulative +1 each day until the PC fails, at which time it resets. Please note that this does not need to be a large fire nor does it mean the PC is foolish enough to do so in front of others. If he fails the Save he will flee somewhere he can set a fire in solitude. For 24 hours after setting a fire, the Pyromaniac gains a +1 Morale Bonus on all rolls.
Some Pyromaniacs are instead drawn to fire. Whenever the afflicted PC sees a fire he must make a Willpower Save (DC 15) or be Fascinated by it. If successful, the Save DC increases by a cumulative +1 each day until the PC fails, at which time it resets.
Seasonal Affective Disorder (http://en.wikipedia.org/wiki/Seasonal_affective_disorder): The PC experiences a downward mood swing during either the summer or winter (although other patterns are not unknown). During this time of the year they experience difficulty waking up in the morning, morning sickness, tendency to oversleep and over eat, especially a craving for carbohydrates, which leads to weight gain. Other symptoms include a lack of energy, difficulty concentrating on or completing tasks, withdrawal from friends, family, and social activities, and decreased sex drive. All of this leads to depression, pessimistic feelings of hopelessness, and lack of pleasure which characterize a person suffering from this disorder. People who experience spring and summer depression show symptoms of classic depression including insomnia, anxiety, irritability, decreased appetite, weight loss, social withdrawal, and decreased sex drive. This causes him to take a -2 Morale Penalty to all attack rolls, saving throws, and checks. When under severe stress such as being wounded, cursed, suffering a negative status condition, or other calamity he must make a DC 20 Willpower Save to avoid the Penalty increasing to -4 temporarily. If he succeeds in making the Save he must continue to make a Daily Save with the Save DC increasing by a cumulative +1 each day until the problem goes away or he fails. Once whatever is causing the increased depression is removed the PC gets a DC 20 Willpower Save to snap back out of it each day, and return to only having a -2 Penalty. Additionally when the Penalty is at the -4 level, the PC must make a DC 20 Willpower Save to allow himself to be convinced to perform any action that will require a Skill Check, Saving Throw, or Opposed Check of any kind. He gets a +1 to the Check per Ally who successfully makes a Diplomacy Check against him (perversely he also takes a -1 Penalty for every Ally who fails that Diplomacy Check). Once the season passes the PC returns to 'normal'.
Social Anxiety Disorder (http://en.wikipedia.org/wiki/Social_anxiety_disorder): The PC suffers from severe anxiety in one or more social situations, or when being observed. Physical symptoms often accompanying social anxiety disorder include excessive blushing, excess sweating, trembling, palpitations and nausea. Stammering may be present, along with rapid speech. Panic attacks can also occur under intense fear and discomfort. Some sufferers may use alcohol or other drugs to reduce fears and inhibitions at social events. Without treatment this also likely leads to substance abuse and eating disorders as well. The PC must make a DC 20 Willpower Save to attend any social function or gathering with more than a handful of people. If they fail they will make any excuse necessary to not attend or leave as quickly as possible. When encountering circumstances that trigger this anxiety, this PC suffers a -2 Penalty on all rolls due to this distraction. While under the effects of caffeine or stimulants this Penalty increases to -4. PC's suffering from Social Anxiety Disorder also have a -2 on all rolls meant to avoid succumbing to addiction. Sufferers sometime also gain Anorexia (see above) or a similar eating disorder, or an addiction to drugs or alcohol.
Extremely powerful entities such as Gods or the most powerful monsters can cause minor strokes or other physical damage which may result in the following insanities (It should be noted these are not common and usually only result as permanent as opposed to temporary insanities):
Body Dysmorphic Disorder (http://en.wikipedia.org/wiki/Body_dysmorphic_disorder): The PC believes some physical aspect of themselves is flawed (or has an exaggerated sense of anxiety about one that is). In game terms, this is similar to Social Anxiety Disorder, with the addition that the PC undergoes extravagant lengths to hide their "flaw", sometimes leading to illness or self-harm. If their flaw is exposed and mocked, the PC will often fly into a Rage (as per the Barbarian Ability listed in the PHB) and blindly attack their insulter, as well as anyone within reach.
Obsessive-compulsive Disorder (http://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_disorder): The PC feels the need to check things repeatedly, perform certain routines repeatedly, or have certain thoughts repeatedly. People are unable to control either the thoughts or the activities. Common activities include hand washing, counting of things, and checking to see if a door is locked. Some may have difficulty throwing things out. These activities occur to such a degree that the PC's daily life is negatively affected. Often they take up more than an hour a day. In game terms this will work similarly to Panic Disorder, with the addition that the PC will also have to make a Willpower Save to avoid his penalty increase if he is prevented from performing his daily rituals as well as in stressful situation. If the penalty increase is triggered by a failure to perform a ritual, then successfully completing the ritual removes the additional penalty.
Psychopathy (http://en.wikipedia.org/wiki/Psychopathy): There is much disagreement and controversy over the use of this term. For purposes of the game this will refer to the theory of "Secondary Psychopathy", i.e. psychopathy created by a horrifically traumatic life. Secondary Psychopaths have definite problems with depression and anxiety, and a heightened sensitivity to fear. They are impulsive, and reactionary risk takers who seek out the forbidden. Unlike Primary Psychopaths they can feel guilt, shame and stress. But they do share their manipulative nature, cruelty, and lack of empathy. For game purposes this is similar to Dysthymia above, with the addition that the PC is a danger to others who may be prone to gambling, addiction or criminal behavior. Each day the PC must make a Willpower Save (DC 10) or engage in risky/criminal behavior. If successful, the Save DC increases by a cumulative +1 each day until the PC fails, at which time it resets. If he succeeds in his behavior without being caught he gains a +1 Morale Bonus on all rolls for 24 hours instead of his usual penalty..
Specific Phobia (Greater) (http://en.wikipedia.org/wiki/Specific_phobia): See Specific Phobia above.