Sanity

Sanity is a representation of how well your character deals with the stress of adventuring, contact with alien entities or other horrors. As you adventure you will take sanity damage.

Each character starts with a sanity score of 8 + their wisdom modifier or their intelligence modifier. Whenever a character gains a level, they gain sanity equal to the average of your wisdom modifier and you intelligence modifier plus 1.

((wisdom mod + intelligence mod) / 2) + 1

When you reach 0 sanity you suffer a sanity break, and suffer an effect determined by the table below. While experiencing a sanity break any additional sanity damage that you take causes an additional sanity break.

Once all effects of all sanity breaks are complete, your maximum sanity is reduced by 2 points for each break suffered and you sanity equal to half your new maximum. A sanity break can be ended early if your sanity is restored to its original maximum. This may not work (based on DM discretion) if your maximum sanity is below half of its initial value.

DM Note

Allow large amounts of sanity healing to end the effect of a sanity break early.

Sanity Break Table

d8	Effect
1	Major Heart Attack + Minor Madness
2	Minor Heart Attack + Minor Madness
3	Major Madness + Minor Madness
4	Major Madness
5	Minor Madness
6	Minor Madness
7	Minor Madness
8	Minor Madness

Minor Heart Attack

A minor heart attack deals 1d8 damage per level. This damage cannot be resisted or reduced aside from a barbarians rage or similar ability.

Major Heart Attack

A minor heart attack deals 1d12 damage per level. This damage cannot be resisted or reduced aside from a barbarians rage or similar ability.

Minor Madness Table

Most minor madnesses are personality changes, more than mechanical changes.

The effects of minor madness last 1d10 x 10 minutes

1d10	Effect
1:	Fainting. You fall unconscious. You wake if you take any damage or a creature takes a turn to wake you.
2:	Jumpy. You gain advantage on initiative tests but have disadvantage on any charisma or wisdom checks.
3:	Paranoid. You do not trust anyone. You cannot be a willing target of a spell.
4:	Overconfident. Your armour class is reduced by 1 and you cannot take cover.
5:	Violent. You must succeed on a difficulty 18 Mental Save to attack any creature besides the closest enemy.
6:	Brash. You cannot move away from any enemy you can see, unless it is towards another enemy.
7:	Gibbering. You cannot speak intelligibly. Casting a spell that requires verbal components requires a concentration check with a DC equal to 10 + 2 x the spells level.
8:	Terror. You are frightened of an object or creature of the GMs choice.
9:	Crawling Skin. You feel like something is crawling over your skin. At the start of each turn you must make a DC 15 wisdom save or spend your turn trying to stop whatever is crawling on you.
10:	Screaming. You are stunned for the duration. Whenever you take damage you can make a DC 15 save to act during the next turn.

Major Madness

Major madness is much more severe than minor madness, and always has some mechanical effect.

1d10	Effect	Duration
1:	Deep Sleep You fall into a deep and restless sleep. Taking damage wakes you up for a number of rounds equal to half the damage taken, but you have disadvantage on all ability checks and attacks for the duration.	1d10 x 10 hours.
2:	Mute You cannot speak or make any other sound. Any spell you attempt to cast with a verbal component fails unless you have a way to not require that component.	1d8+1 days.
3:	Intense Phobia. You gain a permanent phobia of a creature, object, or concept of the DMs choice. You are frightened by the object of your phobia, and whenever you see the object of your phobia for the first time in a round you must succeed on a DC 18 wisdom save or be stunned until the end of your turn.	Permanent. The sanity break from this madness lasts 1d4 days.
4:	Hysterical Blindness. You believe you are blind and automatically fail any checks involving sight. If you are already blind, you are deafened instead.	2d10 hours.
5:	Reckless. You cannot dodge or use cover and your armour class is reduced by 4.	1d6 days.
6:	Crazed. The creature must roll to determine what actions they will take each round if in combat or each minute if not. The table for this roll is below.	1d4 x 10 hours.
7:	Hallucinations. You have disadvantage all attacks, saves, and checks as you attempt to work out what is real and what is just in your head.	1d6 hours.
8:	Personality Change. You undergo a dramatic personality shift. You might become evil, a coward, greedy, an exact copy of a party member or an enemy. You might even act like an animal or some monster. At the end of this break, roll a wisdom save. On a roll of 10 or lower, the effects are permanent, on a result of 20 or lower, some aspects of the personality shift never leave you.	1d6 weeks.
9:	Roll twice on the minor madness table.
10:	Roll twice on this table.

Crazed Table

D8:	Action
1:	Move towards the nearest enemy and make a melee attack if within range. Dash towards nearest enemy if not.
2:	Move towards the nearest cover and cower behind it.
3:	Dance on the spot.
4:	Cry.
5:	Do nothing.
6-8:	Character acts normal but has no awareness of their actions while crazed.

Maximum Sanity Reaching 0

If your maximum sanity reaches 0, you mind is shattered, causing the following effects.

Your maximum sanity becomes 1.
At the start of each day you must roll on the following table until your maximum sanity reaches half its original amount.
In addition, roll once on the supreme madness table. If your maximum sanity is reduced to zero again within this time you must roll twice on the following table each day.

You cannot regain more maximum sanity that your original maximum.

Long Term Break Table

d20	Effect
1:	Roll on the supreme madness table every hour you are awake. The effect lasts one hour.
2-3:	Each time you take damage roll on the minor madness table. This effect lasts one round.
4-5:	The first time you see a hostile creature today you must make a difficulty 15 Mental Save or suffer major madness.
6-10:	The first time you take damage today roll on the major madness table.
11-14:	No effect.
15-19:	You feel a little better. Your maximum sanity is increased by 1.
20:	You feel much better. Your maximum sanity is increased by 2.

Supreme Madness

Lasts until removed. Each extended downtime has a 10% chance to remove it.

At any point you can attempt to ignore the penalties of your madness. Roll a difficulty 25 Mental Save. On a pass you can act normally for a minute. On a fail you take 2d6 sanity damage.

1d10	Action
1:	Shell. You cannot take any action. Any creature can pull you along at half speed.
2:	Babbling. You constantly babble intolerantly. You have disadvantage on stealth tests and saying anything takes 3 times as long as normal. If you try to cast a spell it has a 50% chance of failing as you cast it, unless it does not require you to speak.
3:	Totem. You choose a totem, while more than 30 ft. from the totem you have disadvantage on every roll. If the totem is destroyed you must roll on the minor, major and supreme madness tables.
4:	Night Terrors. The madness has crept into your subconscious and you have awful night terrors when you sleep. Whenever you take a long rest, roll a d6. On a 1, you do not gain the benefits of a long rest.
5:	Death Wish. You must refuse any healing or medicine while conscious and insist that you deserve to feel the pain.
6:	Permanent Damage. Your wisdom score is permanently reduced by 2.
7:	Sanguine Fascination. You become infatuated with blood and will go out of your way to observe bleeding wounds regardless of the context.
8:	Aggressive. You must always attack an enemy if there is an opportunity to do so. At the end of any combat you must succeed at a difficulty 15 Mental Save or attack whatever creatures are around you.
9:	Paranoid. You do not trust anyone. You cannot be a willing target of any spell and cannot sleep while there are other creatures around.
10:	Merciless. You cannot leave an enemy alive.

Losing Sanity

The following effects might drain sanity. When one of these happens you must pass a wisdom save or take the listed sanity damage.

If more than one of these situations occurs simultaneously, you must roll a separate save for each.

For items with no listed DC, the damage is automatic and no save is rolled.

Effect	DC	Damage
Being critically hit.	-	1
Seeing an ally go unconscious from wounds.	15	1
Seeing an ally die.	20	1d3
Going unconscious from wounds.	15	2
Going without a night’s sleep.	10 + the number of nights missed in a row or in the last week (whichever is higher)	1
Killing an innocent being by accident.	10	1d6
Killing an innocent being on purpose.	-	2d6
Seeing an innocent person die by someone else’s hand or from a gruesome accident.	12	1d3

Your GM may create more sanity draining effects and monsters will often do sanity damage.

Regaining Sanity

You can regain sanity by resting. An uninterrupted long rest in a safe place regains 1 point of sanity. Some spells also grant sanity recovery or temporary sanity point, that function in the same manner as temporary hit point, but for sanity.

Getting a critical hit on an enemy regains 1 point of sanity lost during the current combat.

Heroism

Heroism grants temporary sanity equal to the temporary hit points, that last for the same duration.

Healing Word*

Healing word grants 1 point of sanity restoration if used to heal the target from 0 hit points.

Calm Emotions

Calm emotions restores 1d4 sanity. A creature can only benefit from this effect once per long rest.

Lesser Restoration

Lesser Restoration restores 2 sanity to both the target and the caster.

Aura of Vitality

Any creature healed by this spell also heals 1 sanity.

Counterspell

A successful counterspell restores 1 sanity to the caster.

Leomund's Tiny Hut

A long rest inside the Tiny Hut restores an extra point of sanity.

Mass Healing Word

Mass healing word restores 1 sanity to all targets, and an additional 1d4 if used to heal a target from 0 hit points.

Remove Curse

A successful remove curse restores 1d3 sanity.

Mental Barrier

Also grants resistance to sanity damage.

Torture

Your

Players

Do your players complain that the game is too easy? Do you just want them to suffer for the sins of humanity or for playing on their phones at the table?

If the answer is yes, then check out Chloe's Compendium of Cruelty, a collection of nearly all my homebrew content all in one place.

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