Fear and Mental Stress
Gamemastering · Rules Glossary
Due to the nature of their vocation, adventurers tend to be less susceptible to fear and mental stress than common folk. Whereas a farmer might flee in terror from a bear or an apparition, adventurers are made of sterner stuff. That said, certain creatures and game effects can terrify or fray the mind of even the most stalwart adventurer.
If you plan to use any of these rules, discuss them with your players at the start of the campaign.
Fear Effects
Whenever the characters encounter something that is supernaturally frightful, use the Frightened condition as the baseline effect. Fear effects typically require a Wisdom saving throw, with a save DC based on how terrifying the situation is. The Sample Fear DCs table provides some examples.
Sample Fear DCs
| Example | Save DC |
|---|---|
| When the characters open a sarcophagus, a harmless yet terrifying apparition appears. | 10 |
| A character triggers a magical trap that creates an illusory manifestation of that character's worst fears, visible only to that character. | 15 |
| A portal to the Abyss opens, revealing a nightmarish realm of torment and slaughter. | 20 |
Typically, a Frightened creature repeats the saving throw at the end of each of its turns, ending the effect on itself on a success.
At your discretion, a Frightened creature might be subject to other effects as long as the Frightened condition lasts. Consider these examples:
The Frightened creature must take the Dash action on each of its turns and uses its movement to get farther away from the source of its fear.
Attack rolls against the Frightened creature have Advantage.
The Frightened creature can do only one of the following on each of its turns: move, take an action, or take a Bonus Action.
Mental Stress Effects
When a character is subjected to an effect that causes intense mental stress, Psychic damage is the best way to emulate that effect.
The Sample Mental Stress Effects table provides a few examples of such effects, with suggested saving throw DCs and damage. Mental stress can usually be resisted with a successful Wisdom save, but sometimes an Intelligence or Charisma save is more appropriate. On a successful save, a character might take half as much damage instead of no damage, at your discretion.
Sample Mental Stress Effects
| Example | Save DC | Psychic Damage |
|---|---|---|
| A character ingests a hallucinogenic substance that distorts the character's perception of reality. | 10 | 1d6 |
| A character touches a fiendish idol that tears at the character's mind, threatening to shatter it. | 15 | 3d6 |
| A magical trap flings a character into the Far Realm until the end of that character's next turn. | 20 | 9d6 |
Prolonged Effects
Exposure to mental stress can cause prolonged effects. Consider the following possibilities.
Short-Term Effects. The character has the Frightened, Incapacitated, or Stunned condition for 1d10 minutes. This condition might be accompanied by alarming behavior or hallucinations. These effects can be suppressed with the Calm Emotions spell or removed by the Lesser Restoration spell.
Long-Term Effects. The character has Disadvantage on some or all ability checks for 1d10 × 10 hours, stemming from an unwillingness or inability to exert a particular set of abilities. The character might feel enervated and unable to exert much Strength, for example, or become so suspicious of others that Charisma checks are more difficult. These effects can be suppressed with the Calm Emotions spell or removed by the Lesser Restoration spell.
Indefinite Effects. An indefinite effect is a long-term effect (see above) that lasts until removed by a Greater Restoration spell. It can be suppressed by a Calm Emotions spell.
Optional Legacy Reference
The following earlier rules and tables are retained for GM-approved legacy campaigns. They are not the SRD 5.2.1 Fear and Mental Stress rules above; choose one approach rather than applying both.
Legacy Madness Rules
In a typical campaign, characters aren't driven mad by the horrors they face and the carnage they inflict day after day, but sometimes the stress of being an adventurer can be too much to bear. If your campaign has a strong horror theme, you might want to use madness as a way to reinforce that theme, emphasizing the extraordinarily horrific nature of the threats the adventurers face.
Going Mad
Various magical effects can inflict madness on an otherwise stable mind. Certain spells, such as contact other plane and symbol, can cause insanity, and you can use the madness rules here instead of the spell effects of those spells. Diseases, poisons, and planar effects such as psychic wind or the howling winds of Pandemonium can all inflict madness. Some artifacts can also break the psyche of a character who uses or becomes attuned to them.
Resisting a madness-inducing effect usually requires a Wisdom or Charisma saving throw.
Madness Effects
Madness can be short-term, long-term, or indefinite. Most relatively mundane effects impose short-term madness, which lasts for just a few minutes. More horrific effects or cumulative effects can result in long-term or indefinite madness.
A character afflicted with short-term madness is subjected to an effect from the Short-Term Madness table for 1d10 minutes.
A character afflicted with long-term madness is subjected to an effect from the Long-Term Madness table for 1d10 × 10 hours.
A character afflicted with indefinite madness gains a new character flaw from the Indefinite Madness table that lasts until cured.
Table- Madness Short-Term Effects
| d100 | Effect (lasts 1d10 minutes) |
|---|---|
| 01-20 | The character retreats into his or her mind and becomes paralyzed. The effect ends if the character takes any damage. |
| 21-30 | The character becomes incapacitated and spends the duration screaming, laughing, or weeping. |
| 31-40 | The character becomes frightened and must use his or her action and movement each round to flee from the source of the fear. |
| 41-50 | The character begins babbling and is incapable of normal speech or spellcasting. |
| 51-60 | The character must use his or her action each round to attack the nearest creature. |
| 61-70 | The character experiences vivid hallucinations and has disadvantage on ability checks. |
| 71-75 | The character does whatever anyone tells him or her to do that isn't obviously self- destructive. |
| 76-80 | The character experiences an overpowering urge to eat something strange such as dirt, slime, or offal. |
| 81-90 | The character is stunned. |
| 91-100 | The character falls unconscious. |
Table- Madness Long-Term Effects
| d100 | Effect (lasts 1d10 × 10 hours) |
|---|---|
| 01-10 | The character feels compelled to repeat a specific activity over and over, such as washing hands, touching things, praying, or counting coins. |
| 11-20 | The character experiences vivid hallucinations and has disadvantage on ability checks. |
| 21-30 | The character suffers extreme paranoia. The character has disadvantage on Wisdom and Charisma checks. |
| 31-40 | The character regards something (usually the source of madness) with intense revulsion, as if affected by the antipathy effect of the antipathy/sympathy spell. |
| 41-45 | The character experiences a powerful delusion. Choose a potion. The character imagines that he or she is under its effects. |
| 46-55 | The character becomes attached to a "lucky charm," such as a person or an object, and has disadvantage on attack rolls, ability checks, and saving throws while more than 30 feet from it. |
| 56-65 | The character is blinded (25%) or deafened (75%). |
| 66-75 | The character experiences uncontrollable tremors or tics, which impose disadvantage on attack rolls, ability checks, and saving throws that involve Strength or Dexterity. |
| 76-85 | The character suffers from partial amnesia. The character knows who he or she is and retains racial traits and class features, but doesn't recognize other people or remember anything that happened before the madness took effect. |
| 86-90 | Whenever the character takes damage, he or she must succeed on a DC 15 Wisdom saving throw or be affected as though he or she failed a saving throw against the confusion spell. The confusion effect lasts for 1 minute. |
| 91-95 | The character loses the ability to speak. |
| 96-100 | The character falls unconscious. No amount of jostling or damage can wake the character. |
Table- Madness Indefinite Flaws
| d100 | Flaw (lasts until cured) |
|---|---|
| 01-15 | "Being drunk keeps me sane." |
| 16-25 | "I keep whatever I find." |
| 26-30 | "I try to become more like someone else I know-adopting his or her style of dress, mannerisms, and name." |
| 31-35 | "I must bend the truth, exaggerate, or outright lie to be interesting to other people." |
| 36-45 | "Achieving my goal is the only thing of interest to me, and I'll ignore everything else to pursue it." |
| 46-50 | "I find it hard to care about anything that goes on around me." |
| 51-55 | "I don't like the way people judge me all the time." |
| 56-70 | "I am the smartest, wisest, strongest, fastest, and most beautiful person I know." |
| 71-80 | "I am convinced that powerful enemies are hunting me, and their agents are everywhere I go. I am sure they're watching me all the time." |
| 81-85 | "There's only one person I can trust. And only I can see this special friend." |
| 86-95 | "I can't take anything seriously. The more serious the situation, the funnier I find it." |
| 96-100 | "I've discovered that I really like killing people." |
Curing Madness
A calm emotions spell can suppress the effects of madness, while a lesser restoration spell can rid a character of a short-term or long-term madness. Depending on the source of the madness, remove curse or dispel evil might also prove effective. A greater restoration spell or more powerful magic is required to rid a character of indefinite madness.