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Insanity and Dread

Mortal minds are, by definition, limited. When exposed to that which lies beyond, they can be damaged. When filled with the unknown, they can overflow. In the face of the Elder Beings, they can break entirely.

The Mythos entities are a challenge not just because of their physical power and the danger they present but because the mere presence of these soul-shattering beings can fracture a mortal psyche. One cannot so much as learn of the terrors of the Cthulhu Mythos, much less face them in person, without suffering a profound effect, the best-known of which include madness, unreasoning terror, and ongoing neuroses. Beware.

This page will teach you how to implement madness and insanity rules in your game. This also opens up roleplaying challenges in portraying mental quirks that add depth to your characters.

Thereafter, the chapter discusses the sanity-straining depths of the Aklo language.

The final section provides basic rules for visiting the partly mental, yet wholly physical plane of existence known as the Dreamlands: home to Dreamlands cats, the gnorri, and the zoogs, as well as all sleeping material minds.

Introduction

The potent dread and insanity described herein are reserved for truly dire and horrific circumstances. Exposure to the presence of an Elder Being, enduring the grueling mental assault of an eldritch magical attack, or observing a creature whose very presence can instill supernatural fear or unhinge the capacity for sane thought can wreak havoc on the most heroic of adventurers. Of course, heroic characters featured in the typical fantasy setting are exposed to danger, mayhem, and violence as a regular part of their lives. A doughty fighter, faithful cleric, jaded rogue, or potent wizard doesn’t risk dread because of something as minor as being startled by a monster or stumbling upon a dead body. Profoundly disturbing experiences—those that shake the foundations of the mind and spirit—are the hallmark of a Mythos game.

The core of these rules are the concepts of dread and insanity. Dread can have minor effects, such as causing a character to become momentarily shaken, skittish, or distracted, but it can also have long-lasting or even deadly effects such as panic or heart attacks. Sufficient dread can cause a character to suffer insanity, which has more devastating effects in the long term.

It is vital to note that the rules presented here are not intended to be a realistic representation of mental illness, but merely a method to track the effects that exposure to supernatural awfulness can inflict upon heroes and villains alike within the world of a Mythos game. (For more on this point, see “Fantasy Insanity”.)

Dread

Some special abilities, circumstances, and events can lead to a special condition called dread, which functions in many ways similar to exhaustion.

Dread is measured in seven levels, each more debilitative than the last. An effect can give a creature one or more levels of dread, as specified in the effect’s description.

Each dread condition has a save DC used for saving throws against its effects, generally matching the save DC of the effect that inflicted the dread condition. Creatures protected from or immune to the frightened condition are similarly protected from or immune to dread.

The durations of dread effects vary, depending on what caused them. Some dread effects only apply when the source is within line of sight, but some linger even after a victim escapes the source of its dread. If there is not a clear source or the source doesn’t have a clear physical form, the dread effect applies as if it were constantly visible in all directions. Even after the immediate effect ends, a character afflicted with dread retains their current level of dread, so the next source of dread will cause the next higher effect.

If a creature already has dread when it gains dread, its current level of dread increases by the amount specified in the effect’s description or in the appropriate Source of Dread listed below. The longer of the new dread’s duration and the preexisting dread’s remaining duration applies to the new dread total. The dread condition’s save DC becomes the higher of the preexisting dread’s save DC and the new dread source’s DC.

The effects of dread are additive: a creature suffers from the effect of its current level of dread as well as all lower levels. For example, a creature with two levels of dread is already spooked when they encounter a new source of dread, meaning it has disadvantage on ability checks while within line of sight of its source of dread and it can’t move closer to the source of its dread. If it fails its save against gaining 1 level of dread, it immediately increases to level 3 and is afraid.

An effect that removes the frightened condition removes three levels of dread unless it specifies otherwise, and other spells or effects that soothe emotions or reassure their beneficiaries might reduce dread as well (at the GM’s discretion). When a level of dread is removed, the creature no longer suffers from all the dread effects of the removed levels, and all dread effects end if a creature’s dread level is reduced below 1.

Dread also goes away on its own, typically over time.

Most sources of dread have a specified duration, at the end of which the level of dread in all affected creatures reduces by 1 level. If an effect doesn’t list a duration, a creature’s dread reduces by 1 level when the creature finishes a long rest. Note, however, that there may be sources of dread that circumvent this rule and cannot be removed short of magical or some other heroic intervention, or they might be permanent.

Dread Tracker
Level Effect
7 Faint
6 Paralyzed
5 Panicked
4 Staggered
3 Afraid
2 Spooked
1 Disturbed
Dread Tracker Details
Level Effect
1 Disturbed. Must succeed on a Wisdom saving throw against the dread’s save DC to move closer to the dread’s source
2 Spooked. Cannot approach the source of the dread (automatically fails the saving throw listed at level 1); disadvantage on ability checks while the dread’s source is within line of sight
3 Afraid. Disadvantage on attack rolls while the dread’s source is within line of sight
4 Staggered. Insanity risk (see below); drop all held items upon reaching this and any higher level of dread; can’t take bonus actions or reactions; at the start of own turn, must make a Wisdom saving throw against the dread’s save DC; success reduces dread level by one
5 Panicked. Must take the Dash action and move away from the dread’s source by the safest available route on each turn unless there is nowhere to move
6 Paralyzed. Paralyzed (see the condition) with fear, either in immediate prior position or cowering
7 Faint. Fall unconscious from overwhelming shock; must succeed on a Constitution saving throw against the dread’s save DC or die; a successful DC 15 Wisdom (Medicine) check awakens the victim and reduces dread level by one

When an effect that causes dread ends (such as the end of the duration of a revelation’s dread), the dread it caused might not end immediately. Instead, the dread levels of all creatures affected by that source decrease by one level.

The reduced dread’s duration reverts to the longest among all the sources of dread currently applying to the creature, remaining at its new level of dread for the full duration before decreasing again.

Risking Insanity. Dread of level 4 or higher can drive the character insane as described in Insanity addition to its usual effects. This insanity is its own condition and its duration normally outlasts the dread.

Dread and the Frightened Condition. Nonmagical effects that cause the frightened condition (such as a dragon’s Frightful Presence) don’t necessarily cause dread. A creature can be frightened and experiencing dread at the same time without those conditions interacting with each other.

Optional Rule

Dread Resistance If you use dread and insanity in your game, you should strongly consider also using this optional rule. Under this rule, class features and traits that grant immunity to the frightened condition instead grant dread resistance.

Dread resistance gives the creature advantage on saving throws against dread. In addition, dread resistant creatures treat their level of dread as 1 lower than it actually is for purposes of its effects as long as their level of dread is less than 7. For instance, a paladin with dread level 5 is considered to be staggered, rather than panicked.

Sources of Dread

There are three typical catalysts that can cause dread: disturbing discovery (learning dire secret truths of the universe), supernatural influence (being affected by magical fear or insanity effects), and unnamable doom (being exposed to the true awfulness and mind-blasting presence of a Great Old One or Outer God).

Disturbing Discovery

When a character makes a shocking discovery about the world, realizes that their actions have had horrific results, or is otherwise mentally stressed or traumatized by some terrible revelation, there is a chance that the character experiences dread. The GM has final say on which disturbing discoveries have the potential to trigger insanity or dread, but it’s best to save these incidents for key plot points during an adventure rather than to use them frequently.

A character must make a Wisdom saving throw to avoid the dread effect of a disturbing discovery. The save DC and the duration of the dread depend upon how disturbing the discovery or trauma is. Success negates any dread. As a rule, disturbing discoveries shouldn’t require a save DC higher than 20. If a discovery reveals a clear and present danger to the character, that character has disadvantage on the saving throw. The character also has disadvantage on the saving throw if the discovery challenges the character’s traits, bonds, flaws, ideals, or self-concept. If the saving throw is made with disadvantage because the character’s characteristic made them vulnerable, the GM is encouraged to award inspiration to the character. If your game doesn’t use these characteristics or if your game doesn’t emphasize this kind of roleplaying, only impose disadvantage in situations that are suddenly life-threatening.

Minor Disturbing Discovery. A minor disturbing discovery (such as learning that the citizens of the strange town you’re visiting are in fact cannibals, or that the lonely traveler you invited into your home is in fact a vampire) causes one level of dread unless the character succeeds at a DC 10 Wisdom saving throw. The dread decreases after 1 hour.

Moderate Disturbing Discovery. A moderate disturbing discovery (such as learning that the meat pie you ate at the local tavern was made of previous customers or reading a particularly blasphemous and disturbing spellbook) causes two levels of dread unless the character succeeds at a DC 15 Wisdom saving throw. The dread decreases when the character finishes a long rest.

Major Disturbing Discovery. A major disturbing discovery (such as realizing that your father was a deep one or that by activating the strange magical artifact in a dungeon you have transformed the entire populace of the city above into zombies) causes three levels of dread unless the character succeeds at a DC 20 Wisdom saving throw. The dread decreases after 10 days.

Supernatural Influence

When using the insanity and dread system presented in this book, spells and other magical effects that would cause the frightened condition instead cause 3 levels of dread. Contact other plane, confusion, symbol (insanity option) and similar spells and other magical effects that cause insanity cause dread in addition to their usual effects; in this case, the level of dread is equal to half the spell’s level, or one-quarter the monster’s challenge rating for magical fear produced by a monster’s trait or action.

Creatures don’t cause dread innately; they generally only cause dread if they would magically frighten a character or drive a character insane. At dramatic moments, a creature’s appearance or actions might produce a disturbing discovery in characters, as described in the previous section.

Dread from magical fear or from the same creature or kind of creature isn’t cumulative; use only the highest level of dread and longest duration from among these dread conditions. The save DC for this dread is the same as for the spell or magical effect. If the spell or magical effect doesn’t have a save DC, use DC 15 or whatever DC would be most appropriate if one were allowed, such as a save DC equal to 10 + half the source’s challenge rating for a creature or the save DC of a spell scroll of the same rarity for a magic item.

A dread effect caused by supernatural influence lasts as long as the associated insanity or frightened condition would normally last before decreasing.

Unnamable Doom

When a creature is exposed to the area of an Elder Influence, it risks dread. See the Elder Influence rules for details.

Insanity

Insanity is a long-term condition that has specific effects on a character and their abilities. Insanity does not in and of itself cause or worsen dread. Rather, insanity functions similar to a disease: it afflicts a character with a specific disadvantage that remains until the insanity is cured or the character recovers from it. Insanity is less common and immediate compared to dread, but it is potentially devastating over the long term. There are numerous forms of insanity detailed on the following pages. When a character gains an insanity, the GM makes an appropriate selection (or rolls one randomly) from the list. It’s possible to suffer from multiple forms of insanity.

Insanity Strength. All insanities have a save DC that represents its strength. This save DC is equal to the save DC of the source of the insanity. If the source doesn’t have a save DC, use DC 15 or whatever DC would be most appropriate if one were allowed, such as a save DC equal to 10 + half the source’s challenge rating for a creature or the save DC of a spell scroll of the same rarity for a magic item.

Multiple Insanities. Whenever a character gains a new form of insanity, the save DCs of any existing insanities each increase by 2. If the new insanity gained is one the victim is already suffering from, use the higher DC between the two + 5 instead of the character having two instances of the insanity.

Recovering from Insanity. Once every 10 days, a character with an insanity can attempt a Wisdom saving throw against the insanity’s DC. On a success, the insanity’s DC is reduced by 1d4; note that some forms of insanity have effects that trigger if the character fails this save. As long as the insanity has a DC of at least 1, the character continues to suffer the full effects of the insanity, although it becomes easier to resist its effects and recover as the DC goes down. Once the insanity reaches a DC of 0, the character is cured and that particular insanity no longer affects them.

Insanity can be treated by ability checks using the Insight or Medicine skill. First, the insanity must be identified.

A character can identify an insanity with a successful Wisdom (Insight or Medicine) check against the insanity’s save DC. Then, with 1 hour of effort per day for 10 days, the healer can treat the insanity with a Wisdom (Insight or Medicine) check against the same DC at the end of the week. If the check succeeds, the patient receives a +2 bonus on their saving throw to reduce the insanity’s save DC for that 10-day period.

Greater restoration cures one insanity afflicting a creature.

If a target creature has multiple insanities, the spell only affects the insanity with the lowest DC (chosen by the caster among identified insanities in the case of a tie, or randomly if one isn’t specified).

Fantasy Insanity

As noted earlier in this chapter, the insanities listed here are not intended to reflect real-world mental illnesses but are instead supernaturally-induced conditions that afflict imaginary heroes in play. They are included strictly for thematic purposes, as the descent into madness is an inescapable part of a Mythos game.

Considering that mental illness is a real-world affliction that many suffer from and does not necessarily present in an obvious way, it is extremely important that GMs be aware of and considerate of players when it comes to this topic. If a player is uncomfortable with the insanity rules or one of the insanities discussed, do not use it in your game.

It is always incumbent upon the GM to be cognizant of player needs and tailor their games appropriately.

Sources of Insanity

There are four ways in which a character can be driven insane by events that occur during a game: overwhelming dread (having dread of level 4 or higher), catastrophic mental trauma (mental ability score reduction), confusion effects, or effects that directly afflict the character with insanity.

Overwhelming Dread

Whenever a character reaches dread level 4 or a higher dread level, that character must make a special Wisdom saving throw against the dread’s save DC. On a failure, the character gains an insanity related to the source of dread.

Some sources of dread add multiple levels of dread at once. If a character gains multiple levels of dread resulting in a total dread level of 5 or higher, they make that saving throw against insanity with disadvantage.

Catastrophic Mental Trauma

When a character suffers a reduction of Intelligence, Wisdom, or Charisma, they must succeed on a Wisdom saving throw or gain an insanity related to the cause of the ability score reduction. The DC is equal to 10 + the value of the reduction. If a character’s Intelligence, Wisdom, or Charisma score is reduced to 1 or lower, that character automatically develops such an insanity.

Confusion Effects

When a character is affected by a confusion spell or another spell or magical effect that causes the character’s actions to be determined randomly, roll d%. On a result less than or equal to the save DC of the spell or effect, the character gains an insanity that persists after the spell or effect ends.

Other Insanity Effects Rather than becoming unable to act or communicate, a character who fails to save against the detrimental effects of a contact other plane spell or a symbol (insanity option) spell immediately gains a specific form of insanity chosen by the caster.

Variant: Dread and Madness

If dread suits your game but the accompanying insanity rules do not, consider ruling that effects that cause the insanity condition described here instead cause the indefinite madness conditions in the SRD. In such a game, dread has the following changes to its effects.

Dread Level 3. A character that reaches dread level 3 must make a successful Wisdom saving throw against the dread’s save DC or gain a short-term madness.

Dread Level 4. A character that fails the Wisdom saving throw for reaching dread level 4 gains a long-term madness.

Dread Level 5. A character that fails the Wisdom saving throw for reaching dread level 5 gains an indefinite madness.

Types of Insanity

The following table summarizes the most common forms of insanity that plague adventurers who face the horrors of the Mythos. When a character gains an insanity, choose one appropriate to your character or roll on the table to determine the nature of the affliction. Alternatively, the GM can assign an insanity to match the cause or craft a new one altogether.

Random Insanities
d20 Insanity
1–5 Phobia (roll on Random Phobia Table)
6–8 Obsession (typically about the relevant Great Old One or Outer God)
9–11 Erratic behavior
12–13 Hallucinations
14–15 Paranoia
16–17 Delusion
18–19 Dissociation
20 Irrational hatred
Random Obsessions or Phobias
d20 Phobia
1 Animals
2 Being alone
3 Being touched
4 Blood
5 Bodies of water
6 Buildings
7 Cold
8 Crowds
9 Darkness
10 Dead things
11 Enclosed spaces
12 Fiends
13 Fish
14 Heights
15 Insects
16 Large things
17 Loud noises
18 Open spaces
19 Plants
20 Sleep

Delusion

A character suffering from delusion might believe any number of untrue things. For instance, the character could believe they are suffering from a specific physical condition (such as blindness, deafness, incapacitation, paralysis, etc.). It’s also possible the character is deluded about being blessed with something unrealistically positive, such as divine powers, imperviousness to mundane weapons, or immunity to fire. In any event, upon finishing a long rest, the delusional character must succeed at a Wisdom saving throw against the delusion’s save DC or she experiences the full effects of an imagined physical condition until the end of the next long rest, suffering one detrimental physical condition or a –4 penalty to AC and disadvantage on saving throws against a particular sort of attack falsely believed to be harmless (GM’s discretion). On a success, the delusion has no effect until the end of the next long rest.

Dissociation

These insanities are complex and fairly rare. A character with dissociation has a fractured sense of identity. Most cases of dissociation are forms of amnesia, while the remainder are cases of mental fragmentation. All characters with dissociation have disadvantage on Wisdom and Charisma saving throws other than saving throws against the dissociation insanity.

Total Amnesia. Amnesia prevents any access to memories of the character’s name, training, and past. The character can build new memories, but any memories that existed before the amnesia are suppressed. Worse, the amnesiac loses many abilities for as long as the amnesia lasts. Physical memory remains, and the character retains any benefits of reputation, Strength- and Dexterity-based skill proficiencies, and basic combat ability (such as proficiency on attack rolls, etc). However, the character loses all other class features, feats, and Intelligence-, Wisdom-, and Charisma-based skill proficiencies until the amnesia is cured. If a character gains class levels while suffering from amnesia, the levels start at 1st level, as if with no prior levels of any class (even if the class is a class the character had prior to becoming amnesiac). If the amnesia is later cured, the character regains everything lost while suffering from amnesia. The character totals all XP to calculate a new total character level, which might allow the character to gain one or more levels beyond those the character had before becoming amnesiac. Any post-amnesia class levels the character lacks enough XP for beyond the original class levels are lost when the amnesia is cured.

Personality Fragmentation. This is a complicated dissociation that manifests as two or more distinct and different personalities within the same body and mind. The number of additional personalities the victim manifests equals the personality fragmentation’s save DC divided by 5 (minimum 1 extra personality).

The GM should develop these additional personalities in consultation with the player.

Whenever the character finishes a long rest and each time the character gains a level of dread, a character with personality fragmentation must make a Wisdom saving throw against the personality fragmentation’s save DC. On a failure, a different personality takes over. A character’s memories and skills remain unchanged except that the extra personalities have no knowledge of each other and deny that these other personalities exist, sometimes violently. All extra personalities have disadvantage on Wisdom checks.

Erratic Behavior

A character with erratic behavior seems strange and unreliable. Friends can never predict exactly what the character will do next, and sometimes even the character can’t control these actions. This insanity might manifest as unsettling facial tics or violent spasms. A character with erratic behavior has disadvantage on Charisma checks to interact with anyone unfamiliar with this behavior and can never make a passive Strength or Dexterity check because there is always a chance of unintended movement.

Additionally, a character with erratic behavior who enters into a stressful situation such as combat must make a Wisdom saving throw against the erratic behavior’s DC before acting each round. On a failure, the character’s body acts unpredictably, with the GM determining all movement and actions, either at the GM’s discretion or as described in the confusion spell. This unpredictability does not cause dread or insanity on its own. A spell or effect that removes or suppresses enchantments or possession allows the character to act normally while the character is under the spell, or for 8 hours if the effect is normally instantaneous.

Hallucinations

A hallucinating character perceives things that aren’t there. These perceptions can be visual or auditory or might affect the other senses. It is difficult to tell the false perceptions from the real. The character has disadvantage on Wisdom (Perception) checks (and thus their passive Perception is reduced by -5). A hallucinating character must make a Wisdom saving throw against the hallucinations’ save DC upon entering a stressful situation (such as combat). On a failure, the character is overwhelmed by a barrage of sensory input, suffering disadvantage on all attack rolls.

A hallucinating character can attempt a new Wisdom save at the end of each round to end the effect. The effect ends immediately if the character is killed or knocked unconscious. A spell or effect that removes or suppresses enchantments or possession allows the character to ignore these effects while the character is under the spell, or for 8 hours if the effect is normally instantaneous. A character can use an action to counsel the hallucinating character to negate the hallucinations effect with a successful Wisdom (Insight or Medicine) check against the hallucinations’ save DC.

Irrational Hatred

This complex insanity fills the victim with hatred for the world. At the end of each long rest, the character must make a Charisma saving throw against the irrational hatred’s save DC. On a failure, the character’s alignment becomes chaotic evil until the end of the next long rest.

While affected by the irrational hatred, the character can’t help but plot and plan the death and destruction of friends and enemies alike. The hateful character is skilled at hiding this hatred, feigning sanity, and resisting treatment; the character always attempts Charisma (Deception) checks when someone tries to diagnose the condition, and gains advantage on this check.

For the most part, the impact of irrational hatred must be roleplayed, although not all players find entertainment in roleplaying someone who’s trying to do in their friends. In such cases, the GM should choose another insanity or should plan to use irrational hatred only when the player’s fun won’t be spoiled by giving over control of the character to the GM while the insanity has control.

Obsession

Sometimes referred to as a fixation or mania, the character develops an irrational and troubling obsession with a particular object or situation. A character who gains this insanity often develops an obsession with the source of the insanity.

In Mythos adventures, the character’s target of obsession is generally closely associated with the most relevant Great Old One or Outer God.

It is tragically common for an investigator originally opposed to a Great Old One or Outer God’s goals to become obsessed in the course of researching and fighting the entity, only to ultimately help it simply to satisfy the resulting obsession.

A character with obsession has disadvantage on ability checks when the object of obsession is observable but not in the character’s immediate presence.

Additionally, if the character is directly confronted by the obsession or reaches it in some way, the character must succeed at a Wisdom saving throw against the obsession’s DC or become completely enthralled by the target. (For instance, a book-obsessed character might have disadvantage while in a library but only become enthralled when actually reading a book, whereas an egomaniacal character might have disadvantage in a room full of mirrors but become enthralled when actually holding a mirror or within 5 feet of a doppelganger.)

While enthralled, the character can do nothing but attempt to interact with this object in a manner appropriate to the obsession (such as compulsive reading, fawning over their own appearance, or falling down in worship of a Great Old One). The character still tries to avoid harm, but otherwise remains fixated. The character can make a new saving throw before taking a turn each round; on a success, the character is no longer enthralled and compelled to interact with that target of obsession. If exposed again, however, the creature must make a yet another saving throw to avoid becoming enthralled again.

Paranoia

A paranoid character is convinced that many distant and nearby creatures, potentially including anyone or everyone, are enemy conspirators.

A paranoid character cannot benefit from or use the Help action without succeeding on a Wisdom saving throw against the paranoia’s save DC.

A paranoid character has disadvantage on Charisma checks.

A paranoid character has a –2 penalty on Wisdom saving throws.

A paranoid character cannot willingly accept aid (such as healing or a beneficial spell) from another creature without first suppressing the paranoia, which requires a successful Wisdom saving throw against the paranoia’s DC.

Phobia

A phobia is an irrational fear of some (usually commonplace) object or situation. A character with a phobia automatically gains one level of dread upon observing the feared object or situation. Additionally, if a phobic character is directly confronted by the feared object or situation, the character must succeed at a Wisdom saving throw against the phobia’s DC or gain two additional levels of dread. In either case, the dread is reduced after finishing a short or long rest away from the source of fear.

Playing Characters with Insanity

In the course of interacting with horrors from beyond space and time, it is not just possible but very probable that a character may go mad from unwanted revelations, terror, or incomprehensible new realities. But this doesn’t mean the character ceases to be playable; now the player gets to play a character with interesting new quirks and behaviors and really stretch their roleplaying legs.

Degrees of Insanity

The first thing you need to determine is just how insane a character is. For ease, madness can typically be subdivided into three categories.

First Degree: Neurotic After-effects

After a brush with dread, or after recovering from a psychotic episode, it is unlikely that a person will completely return to normal. Instead, they will have quirks, nervous tics, and a somewhat shaky grasp of the world. If their insanity was instigated by reading terrible tomes, for instance, then other books may make the character nervous or even cause panic attacks. The character may hoard objects or avoid keeping anything. They may be constantly concerned about the possibility of insects crawling under their skin or constantly scratch at their exposed skin. The character might hear voices but (usually) knows that they are not real.

Look for quirks to make your character fun, but not unplayable.

Second Degree: Insane but Alert

At this stage, the character, while clearly insane, is aware of their surroundings and capable of interacting with other characters, and can take normal actions, such as walking, eating, and possibly fighting. Picture a character in a film or book who has gone beyond being simply “odd” to the point of demonstrating unusual behaviors and attitudes at all times, which flavor their methods and interactions with others but still allow them to function.

Remember that playing an insane character is not the same as playing an annoying character. Instead, strive to play your insane character with humor and intelligence.

One critical aspect to madness is to never confuse it with stupidity: an insane character may interpret their surroundings or events incorrectly, but within their (skewed) worldview, their actions are often logical. Neither should you confuse insanity with comic relief: an insane character can be entertaining but should not be a constant subject of ridicule or the butt of every joke. As with any character, your character should enrich the game rather than detract from it.

Also be aware that while your character’s view of reality may be distorted, it is also possible (even likely) that due to their contact with the Mythos, their view may be closer to the actual truth. For example, a person who sees things or hears voices that no one else can see or hear may seem insane, but the person’s condition could be caused by a permanent alteration to their brain that allows them to see or hear real entities in a parallel dimension to our own!

Most importantly, there is no way for anyone to confirm whether the voices and hallucinations are real, short of acquiring the insanity themselves.

Consider David Cronenberg’s The Fly (spoiler alert): the main character, who is genetically half-fly, wants to return to his human condition, and comes up with a plan to place his girlfriend, pregnant with his child, into the teleporter and merge with her. The resulting monstrosity will have three times as many human genes as a fly, and thus make him far more human. This is perfectly logical yet horrifying and certainly not something a sane person would do.

Second Degree characters sometimes behave as villains, though this is not necessarily intentional—rarely do they see their motivations as evil, and more often they are attempting to do the right thing. They can be persuaded or tricked into a particular action by other characters who pander to their madness or try to get them to rise above it.

Third Degree: Stark Raving

Sometimes a character has been driven so insane that the player is forced to relinquish control to the GM. The sorceress is cowering in a corner, clawing at the air and babbling in an unknown language, or the paladin throws away his weapons and runs blindly through the forest shrieking.

Typically, this extreme insanity is only a temporary condition, and eventually the player can regain some control. Of course, in some cases, this can indeed be permanent, in which case the character becomes an NPC and a tool for the GM to use, and is retired from active play. The player should create a new character to continue the adventure.

This possibility is something especially important to discuss with all at the table before it comes into play.

This is not necessarily a “failure” condition, either. Many horror games end with at least one player going mad in an effort to stave off an even worse fate for others. As long as it produces a good, compelling story, you have done right by your character.

Section 15: Copyright Notice

Sandy Petersen’s Cthulhu Mythos, © 2018, Petersen Games; Authors: Sandy Petersen, David N. Ross, James Jacobs, Arthur Petersen, Ian Starcher.