Sanity

Abominations from deep dimensions. Vile undead fiends. Knowledge that man was not meant to know. These are all things that can cause a normally well-adjusted individual to lose their grip on reality. The following rules assist in utilizing sanity in D&D games.

Sanity Score

Characters start with a number of Sanity points equal to five times their Wisdom score.

Whenever a character is exposed to something that could affect their sanity, roll 1d100 against their current Sanity score:

• If the roll is equal to or less than the score, the character is unaffected

• If the roll is higher than the score, the character is affected as follows:

Missed Roll By → Effect

• 1–10: Stunned

• 11–20: Sickened

• 21–30: Nauseated

• 31–40: Shaken

• 41–50: Frightened

• 51–60: Panicked

• 61–70: Cowering

• 71–80: Paralyzed

• 81–90: Helpless

• 91–100: Dead (Fortitude DC 20 negates; on success, becomes Helpless)

Sanity Modifiers

Aberrations, Oozes, and Undead make the Sanity roll more difficult:

• Add (Creature CR – Character Level) to the roll (minimum +0)

Characters must also make a Sanity check when using the Forbidden Knowledge skill:

• Add ½ the DC of the check to the Sanity roll

Fear Immunity

Paladins and characters immune to fear must still check:

• Roll 1d20 + character level vs DC 15

• Success: No Sanity check required

• Failure: Make the Sanity check as normal

Insanity (0 Sanity)

When a character reaches 0 Sanity, they are driven insane. The DM selects one of the following effects based on the cause.

Insanity Effects

• Autonomic Hyperactivity - Sweating, racing heart, dizziness, clammy hands, flushed or pallid face, rapid pulse and respiration even when at rest. All attack rolls, saves, and checks take a -2 penalty.

• Bipolar Mood Disorder - The character oscillates between mood states, sometimes staying in one mood for weeks at a time, sometimes rapidly switching between them.

• Compulsions - The character insists on performing ritual actions (such as touching doorways in a specific pattern). This behavior lasts 1d10 rounds and may override survival instincts.

• Depression - Persistent fatigue, hopelessness, and possible hallucinations. All attack rolls, saves, and checks take a -4 morale penalty. The character may withdraw entirely from activity.

• Dissociative Amnesia (Psychogenic Amnesia) - The character cannot recall important personal information. DC 20 Will save required to remember. Optional: reset Forbidden Knowledge to +0 and max SAN to 99.

• Dissociative Fugue - The character abandons their identity and assumes a new one.

• Dissociative Identity Disorder - Multiple personalities with distinct behaviors and outlooks. Same stats, different roles.

• Expectations of Doom - Constant dread and anticipation of disaster. All attack rolls, saves, and checks take a -2 morale penalty.

• Intermittent Explosive Disorder - Sudden violent outbursts and destructive behavior.

• Mania - Hyperactivity, delusions, reckless behavior. All attack rolls, saves, and checks take a -4 morale penalty.

• Motor Tension - Restlessness and instability. –2 penalty on attack rolls, Fortitude & Reflex saves, and Str/Dex/Con checks.

• Obsessions - Intrusive thoughts dominate attention, especially under stress, interfering with concentration.

• Obsessive-Compulsive Disorder - Obsessive thoughts and/or compulsive behaviors.

• Panic Disorder - Sudden episodes of intense fear with physical symptoms such as trembling, sweating, and breathlessness.

• Personality Disorders - Long-term behavioral dysfunction. –4 penalty on Charisma-based checks; NPC attitudes shift negatively.

  Types include:

  • Antisocial

  • Avoidant

  • Borderline

  • Compulsive

  • Dependent

  • Histrionic

  • Narcissistic

  • Passive-Aggressive

  • Paranoid

  • Schizoid

• Phobia - Irrational fear of a specific object or situation. DC 15 Will save to confront; –2 morale penalty while exposed.

• Post-Traumatic Stress Disorder - Recurring flashbacks, emotional withdrawal, and reliving trauma.

• Vigilance - Insomnia, irritability, and inability to focus. –4 morale penalty on Will saves and Int/Wis/Cha checks.

Healing Sanity

• Characters regain Sanity equal to level + CHA modifier per session

• Characters suffering from insanity do not regain Sanity

Recovering from Insanity

• Once per session, a character may attempt a Will save (DC 25)

• Success removes the insanity

• The character may then begin recovering Sanity normally