Madness saves represent the power of terror — a role playing tool to help players visualize the hysteria that often clouds the minds of characters in classic tales of horror. The Judge can always consider these saving throws optional. If a player portrays the stark terror of her hero without prompting, no die roll is necessary.
Note: Creatures without Intelligence scores are immune to Madness effects.
Making the Saving Throw
Madness saves are considered Will saves in all respects. Anything that modifies a Will save likewise modifies Madness saves; anything that modifies saves vs. fear effects modifies Fear saves. Madness saves all use the same basic mechanic: a Will save against a specified DC. Specific DCs depend on the situation and type of check being made and are provided in the following sections. Luck do not affect Madness saves; they are outside the purview of luck and are not "active" effects that would be resisted. Divine effects do aid Madness saves, however. If a character succeeds at the Will save, then there is no effect, and she is immune to that specific source of madness for 24 hours.
If a character fails the Will save, then the margin of failure determines the result. Subtract
the final check result from the DC; this result determines whether the character suffers a minor,
moderate, or major effect.
Failure Margin Effect
1-2 points Minor
3-4 points Moderate
5-8 points Major
8+ points Major, plus additional effect
When determining the results of failed Madness saves, the player also needs to roll
1d4 to select a specific effect.
Recovery Checks
A character who fails a Madness save needs to make recovery checks to shake off its effects. Recovery checks are actually just Madness saves, usually with the same modifiers and DC. However, succeeding at a recovery check lessens the severity of a Madness effect; failing a recovery check does not cause additional ill effects.
Madness Saves
Failed Madness saves can cripple a character; fortunately, they're also the least common type of
effect. Make a Madness save in the following three situations:
• The character makes mental contact (using spells, special abilities, and so on) with any
darklord, aberration, elemental, ooze, outsider, plant, or insane mind (any creature suffering from
a Madness effect).
• The character is the victim of "gaslighting," a purposeful attempt by another party to drive her
insane.
• The character suffers a total catastrophe. This can include witnessing the brutal destruction
of the rest of the party, leaving the character to face the threat alone; a paladin being stripped of
her powers for her misdeeds; suffering an involuntary alignment change; or being subjected
to a horrific physical transformation..
Determining the Madness Save DC
A Madness save's DC is determined on a case by-case basis.
Mental Contact:
If a Madness save is prompted by contact with an alien or insane mind,
the DC is 10 + 1/2 the contacted creature's HD + contacted creature's Personality modifier.
Gaslighting:
Gaslighting comes in two varieties. If an opponent tries to drive a character mad
with a spell or other magical effect (such as bestow curse or wish), then default to the saving
throw indicated by that spell (typically a Will save). That saving throw stands in for the Madness
save. One character can also gaslight another through nonmagical means. To do this, the perpetrator
must gain the victim's trust and remain in close proximity to the victim for thirty days, using
that time to slowly convince the victim that her sanity is slipping away. At the end of the thirty days, the perpetrator must make an opposed personality check against the victim's intelligence check. If the victim fails this check, she has been driven mad; as with other Madness saves, the degree of failure determines the result (subtract the victim's Intelligence result from the perpetrator's Personality result).
The perpetrator can select a specific Madness effect from the selected category if he wishes.
If the victim's Intelligence check defeats the perpetrator's Personality check, she is unaffected. If she
succeeds by 10 or more points, she immediately becomes aware of the perpetrator's failed
gaslighting attempt. If the perpetrator is not detected, he can try again (with each attempt
taking another thirty days).
Total Catastrophe:
Madness saves prompted by personal catastrophes can be considered a particularly shattering form of a Madness Save (Moderate or above).
Failure Results
Failed Madness saves can quickly hinder or cripple a character. the player should roll 1d4 and compare it to the failure category to select an effect. In addition to the listed Madness effects below, all failed Madness checks cause effective ability decreases to Intelligence and Personality. (Roll
separately for each ability score.) A character with a minor Madness effect suffers a temporary decrease of 1d6 points per ability. The character regains 1 point in each ability score per hour. A character with a moderate Madness effect still suffers an effective decrease of 1d6 points per
ability, but these points cannot be regained without effort. See "Recovering from Madness" below.
A character with a major Madness effect suffers an effective decrease of 1d10 points per
ability. As with moderate effects, these points cannot be regained without effort.
If a character fails a Madness save by 10+ points, her mind is shattered. Unable to function,
she immediately drops to 1 hit points and starts to die. If she survives this shock to the system, she
suffers a major Madness effect and an effective ability decrease of 1d10 points per ability.
Minor Madness Effects
1d4 Effect
1 Blackout
2 Denial
3 Horrified
4 Unhinged
Moderate Madness Effects
1d4 Effect
1 Delusions
2 Depression
3 Hallucinations
4 Paranoia
Major Madness Effects
1d4 Effect
1 Amnesia
2 Multiple Personalities
3 Schizophrenia
4 Suicidal Thoughts
All Madness effects described below are in addition to the effective ability decreases detailed
above. As a note, minor Madness effects tend to be forgiving and pass within a few hours. Moderate effects can be troubling, but PCs can usually continue to function. Characters suffering from major Madness effects often pose a danger to themselves and others and require close supervision.
Blackout:
The character is merely shaken at first. However, she will not recall anything in the
time period between (and including) the scene that prompted the Madness save and when she regains
the last of her decreased ability scores. If the character is alone, the Judge may simply cut to when she "comes to," wandering and alone, with no memory of how she came to be in her
current location. Some spells, such as modify memory, can restore lost memories.
Denial:
The character's mind refuses to accept the existence of the threat that prompted the Madness save. Until she regains all decreased ability scores, she acts as if this threat simply does not exist. Denial provides the character with an effective +4 insight bonus to any Will saves against that threat's attacks but otherwise offers no protection. When all ability scores are regained, the character once again acknowledges the existence of the threat (but loses the insight bonus).
Horrified:
The character suffers a moderate Horror effect (determined randomly). This Horror effect's duration lasts only until the character regains all decreased ability scores.
Moderate Horror Effects
1d4 Effect
1 Nightmares
2 Obsession
3 Rage
4 Revulsion
Nightmares: For the moment, the character is merely shaken. This Fear effect lasts 5d6 rounds.
However, the next time the character tries to go to sleep, the horrific events of this scene will play
themselves out again in his mind, causing the character to wake with a scream after only 5d6
minutes. The nightmares return every time he tries to sleep, preventing rest. For as long as this Horror
effect lasts, the character cannot regain arcane spells, and each full day without rest incurs a
cumulative -1 morale penalty to all attack rolls, saves, and checks, to a -4 maximum penalty.
Lack of sleep also erodes the character's health. Without rest, he cannot regain hit points
through natural healing. Sleep can grant dreamless rest, allowing the character to regain spells and negate accumulated penalties. If the character does not receive a sleep spell every night, however, the nightmares begin again. Elves neither truly sleep nor dream and thus are immune to this effect; players of elven characters should reroll the d4 or choose another moderate effect instead.
Obsession: The character is unable to shake this horrific memory. He continually replays the
events in his mind, mumbles about them under his breath, and tries to bring all conversations back to
this terrible topic. His obsessed mind becomes clouded, and he seldom sleeps. With each day of restless obsession, he suffers a cumulative -1 morale penalty to initiative and Listen, Search, and Spot
checks, to a maximum penalty of -4. The character ignores his health while obsessed. He cannot regain hit points through natural healing, and each full week without rest also inflicts
1 point of effective Constitution decrease. Once the character recovers from Obsession, lost
Constitution points return at the rate of 1 per day. (See "Recovering from Failure," below.)
Rage: The character's mind is overwhelmed by a primitive, mindless fury directed toward the
source of horror. He must drop anything in his hands that is not a weapon, then rush forward to
attack the object of his hatred in melee. This blind fury acts as a barbarian's rage ability, with the
following exceptions: unlike a barbarian, the character is not in control of his actions. He cannot
retreat from battle and will not stop attacking the subject of his rage even if it is destroyed. He must
also move toward the subject using the most direct route, even if this means passing through threatened areas. If anyone — even an ally — tries to block his path and he cannot move around, he must fight his way through the obstacle. The rage lasts a number of rounds equal to 3 + the character's (heightened) Constitution modifier. When the rage ends, the character regains control
of his actions, but he is fatigued.
Revulsion: the character is shaken if exposed to anything that merely reminds him of the horror scene. A character horrified by a vampire attack may suffer repulsion upon seeing a large swarm of bats or hearing the conversational mention of a vampire, for example.
Unhinged:
The portion of the character's mind that should have gone mad simply shuts down instead. This leaves the character able to function but affects her personality. but her alignment temporarily changes (roll 1d2 to randomly select a new alignment, omitting the character's original alignment from the options). A Intelligence check (DC 20) can reveal that the Unhinged character is "not quite herself," assuming it isn't obvious. The character regains her normal alignment (but loses the morale bonus) when all decreased ability scores are restored. An alignment change due to this Madness
effect does not cause an additional Madness check.
Delusions:
The character believes something about herself that is simply not true. The nature of this delusion is usually tied into the event that provoked the Madness save. Examples might include a character who believes she has endless wealth (paying for services with pebbles she insists are rubies), believes she transforms into a wolf under the light of the full moon (and insists she must be caged), or believes that she is a specific NPC ("I am Count Strahd! Bow before me!"). The character can perform actions only if she can rationalize them within the context of her delusion. For example, a character who believes she is actually a vampire would not be willing to expose herself to sunlight.
If a character ever performs an action that should be "impossible" within the context of her
delusion (in other words, if the player cannot immediately provide a rationalization for the action),
the character must make an immediate Madness check at DC 15.
Depression:
The character is overcome by a deep melancholy, sapping away her will to live and her interest in the world around her. Such a character just wants to be left alone; she will not suggest ideas, give commands, or otherwise direct other characters. In fact, in any given situation, the character must make a Will save at the same DC as the failed Madness save to take any action whatsoever. If the character fails this Will save, she will do nothing at all, even in dangerous situations. In a combat situation, she cannot take any actions and is considered flatfooted.
Even if the character is motivated to act, she does so listlessly and reluctantly. She can follow
the instructions of allies, but she suffers an effective -4 morale penalty to all attack rolls, loses
any Dexterity bonus to AC and Reflex saves, . On the other hand, the character's utter lack of interest in her surroundings actually provides her with an effective +4 insight bonus to all subsequent Madness saves.
Hallucinations:
The character perceives something in the world that simply does not exist. In a sense, Hallucinations can be considered the "external" companion to the "internal" Delusions effect. As with Delusions, the nature of the hallucination is usually related to the event that prompted the failed Madness check.
Examples: A character might believe that she can see ghosts, that biting insects have infested her
armor, or that illithids visit her at night. She might even occasionally encounter an NPC who actually
exists only in her mind.
In a sense, a hallucination can be thought of as a phantasm spell on the level of a major image,
but one where the insane character is both caster and subject. As with illusions, the Judge should
present hallucinatory episodes as real events when they first manifest. Menacing hallucinations may
provoke additional madness saves (DC depends on the specific scene; see the respective sections on
determining DC). Hallucinations can even attack the character, though they inflict only subdual
damage, as the character merely believes she is being harmed. Characters have little mental defense against their own inner demons. Thus, a hallucinating character suffers a -2 morale penalty to all Madness saves provoked by her own visions.
If a character somehow becomes aware that her hallucinations are just that, she must still concentrate to convince herself that the visions are not real. This works just like disbelieving illusions; to dispel a hallucination, the character must make a Will save at DC (13 + character's Personality modifier). Unlike with illusions, however, the reassurances of allies cannot grant a hallucinating character any bonus to her Will save. An attempt to disbelieve a hallucination is a standard action and can be retried each round. If a character successfully disbelieves a hallucination, the episode still continues for another 1d4 rounds. That hallucination can no longer provoke saves, however, nor can it inflict subdual damage.
Judge Tips: One way to present hallucinations is to secretly inform the other players of the nature of
the character's madness. Later, once those players know that the episode the Judge described won't be
real, The Judge can present the episode to the group as a real event, and only the hallucinating character will react as if the threat is real — adding to the insane character's confusion.
The Judge can then enhance this "rubber reality" scenario by letting the hallucinating character see
a real threat that mimics a recurring vision. As an example, a character who hallucinates about
monstrous wolves might be on watch, alone, when she spots a real pack of dire wolves skulking
around the campsite. The other characters would then have to guess whether she was merely
"crying wolf again.
Paranoia:
The character believes that she exists at the center of a conspiracy dedicated to her
destruction. No amount of rational argument can convince her otherwise. Although the character's
madness does not extend to actual hallucinations, the Judge should present all NPCs and conversations with other characters in a menacing light. The Judge might drop subtle visual clues that other characters are inhuman, or thread vague, easily misinterpreted "threats" into NPC dialogue.
As with hallucinations, the Judge may want to give the other players secret signals that the scene is not being presented quite as it actually exists, or the Judge may want to focus on the paranoid character's interaction with NPCs only when separated from other PCs. This avoids the extra work of explaining what's really happening to the other players. The paranoid character must succeed at a Will save with a DC equal to that of the failed Madness save to place any trust in other characters. If the character fails the Will save, she must refuse all offers of help as being "obvious traps." If a paranoid character ever does come upon actual evidence that she has been betrayed or that others are conspiring against her, she must make an immediate Madness save (at DC 12 + character's Personality modifier).
Amnesia:
A much more disabling form of the Blackout effect, Amnesia is the result of an affected mind's desperate attempt to shield itself from the memory that provoked the failed Madness save. Throwing the baby out with the bathwater, the amnesiac character immediately blocks out all memory of the maddening event — along with many of the months or years that came before it. If a failed Madness save results in an Amnesia effect, the Judge should roll d%. Multiply this percentage times the character's total levels (rounding down). The character then receives that many negative levels.
Although an amnesiac character still has access to all of her skills, she loses all memory of events since gaining those levels. A character who acquires a number of negative levels equal to her character level regresses to childhood.
Example: A 8th-level warrior fails a Madness check, resulting in Amnesia. The Judge rolls d%,
with a result of 48. The warrior then acquires three ( x 48% = 3.4, rounded down) negative levels.
This character would not remember any events he has witnessed or any people he has met since
becoming an 5th-level warrior. Restoration spells cannot remove these negative levels; they are caused by memory loss, not negative energy.
Multiple Personalities:
The character's psyche makes a desperate attempt to contain the mental trauma it has suffered by splintering into separate identities. The character retains a core personality, 1d5 fragments, and 1d10 alter egos. The core personality is the character's original persona. It has access to all of the character's memories, skills, and abilities. Fragments are partial personas, easily described in a single phrase, such as "coin collector," "sleepy child," or "talented dancer." The player can assign a single skill or ability to each fragment. Fragments can use their one talent if called upon, but they always ignore anything that has no relation to their single subject. Alter egos are fully formed personalities. Each alter ego considers itself a distinct individual, but alters often believe that their race, class, or even gender differs from the core personality. As with Delusional characters, these alter egos cannot be convinced that they are not as real as the core personality. The player should flesh out the persona of each alter ego:
• Roll 1d6 to determine each alter ego's approximate
age.
1: Child.
2: Adolescent.
3: Adult.
4: Middle aged.
5: Old.
6: Venerable.
• Roll 1d6 to determine each alter ego's supposed
sex and race.
1: Same sex, same race.
2:Male, same race.
3: Female, same race.
4: Male, different race.
5: Female, different race.
6: Same sex, different race.
Most alter egos who believe themselves a different race will still consider themselves humanoids, but some alter egos may believe they are giants, fey, or even magical beasts.
Alter egos have access to all of the core personality's skills and abilities, but they will not use them if doing so is "out of character." For example, a wizard's alter ego that believes itself to be an ogre
distrustful of magic would not cast spells. The player should keep a numbered list of her
hero's fragments and alters for ease of reference. Whenever a character suffering from Multiple
Personalities has to make a Will save, she must also make an immediate additional Will save equal to the failed Madness save's DC or randomly switch personalities (as a free action). The character should also make a Will save (DC 15 + character's Personality modifier) each time she rests. If the character succeeds at the Will save, she wakes up as the core personality. If she fails, she switches to a random persona. The core personality has no conscious memory of time spent in other personalities, but the character does not acquire negative levels as with Amnesia. Alter egos typically are aware of each other and can "leave messages" for each other if they wish. It is not uncommon for alter egos to dislike each other or the core personality.
Schizophrenia:
The character's personality suffers a serious collapse. As the character's sense of self erodes, she can experience drastic and unpredictable personality shifts. Once every week, and whenever the character makes a Will save of any kind, she must succeed at a Will save (DC 15 + character's Personality modifier) or have her alignment immediately and randomly change.
The player should roll 1d4:
(1: Lawful. 2: Neutral. 3: Chaotic.4: Original alignment)
A character might be a saint one moment, a monster the next.
An alignment change due to this Madness effect does not cause an additional Madness check.
Suicidal Thoughts:
This is a more serious form of the Depression effect. In addition to all of the
effects detailed under Depression, the character's will to live hangs by a thread. If the character fails any subsequent Madness saves, she must soon (within an hour) make an attempt to take her
own life. The character makes the suicide attempt via the most efficient means at her disposal: leaping off a high balcony, drinking poisonous chemicals, hurling herself into a river, and so on. A character can also use a piercing or slashing melee weapon to inflict a coup de grace against
herself. This is also possible with some ranged weapons, such as crossbows and firearms.
Additional Failures
If a character fails another Madness save while already suffering a Madness effect, do not roll 1d4 to
determine a new effect. The character's mind, already insane, merely sinks deeper into its existing
dementia. Ability score decreases are cumulative with multiple failed Madness saves, however.
If any of the character's mental ability scores ever drop below 3, she becomes what is commonly
known as a lost one — a walking catatonic whose mind was shattered by memories too horrible to bear. The character becomes an NPC until she has at least a 3 in all mental ability scores;
until then, the character eats and drinks if fed, walks if led, and may occasionally mumble some gibberish, but otherwise she can take no meaningful actions.
The Judge can shape a lost one's personality by looking at which ability score has dropped to 1 or 2.
A lost one with minimal Intelligence may seem like a cheery and friendly fellow, but he might have
absolutely no short-term memory. He is unable to remember anything about anyone from one minute
to the next. A lost one with minimal Personality might have a vibrant memory but would be completely stymied by any kind of external task, such as opening a door latch or changing his clothes. A lost one with minimal Intelligence and Personality might wander in a daze, mumbling strange rhymes, and is seemingly unable to register the existence of other creatures. If any ability score drops to 0, the character slips into complete catatonia If both ability scores are raised above 0 again, the character wakes up as a lost one.
Madness and Alignment
Some Madness effects can cause a character's alignment to temporarily change. This is an involuntary
alignment shift but does not require an additional Madness save. Some classes require specific
alignments, like the lawful good paladin. In these cases, the insane character should be considered
an effective "ex" member of that class and may or may not lose class abilities. This loss of class abilities is only temporary; because the alignment change is involuntary, the character is not considered to have actually abandoned the class.
When the Madness effect causing the alignment change is removed, the character's original
alignment is restored and she can continue to gain levels in that class as normal. Divine spellcasters
such as the cleric, druid, or paladin may be required to atone first, however.
Recovering from Madness
The road from madness to sanity is often long and difficult. Madness effects are removed when
all ability points lost to the failed Madness save are regained. In the case of minor Madness effects,
this period is mercifully short: never longer than 6 hours. Moderate and major effects require much
more effort to shake off. Several methods are available to characters in need of recovery:
Peace and Quiet:
If the character rests for thirty days without failing any subsequent Will saves, she can make a recovery check (a Madness save) against the same DC. If this check succeeds, she regains 1 point in one of her decreased ability scores. While the player can choose which ability score to place the point in, the fastest road to recovery lies in restoring Personality to normal first. The character can attempt a new recovery check once per restful month against the original DC until Intelligence, and Personality return to normal. However, particularly if the character's Personality score was drastically lowered by the Madness save, the DC may be so high that the character cannot succeed. In these cases, the character needs to turn to outside help.
Magic:
If available, magic is the quickest and most efficient method of recovery. Restoration can
restore drained ability scores but requires three castings to remove a Madness effect (one casting
to restore each ability score), while the spells greater restoration and heal can each cure madness at a stroke. Note that of these spells, only heal can restore memories lost to a Blackout or Amnesia. Modify memory can also restore lost memories, but it may require multiple castings to
recover all lost memories.
Hypnosis:
If the character does not have access to magic, access to a character with the Hypnosis skill is the next best option. The hypnotism spell can be used in the same way; use this
system, but the spell's increased efficiency grants the subject a +2 bonus to her recovery check.
Hypnosis is a new technique, first developed by (and still largely limited to) the alienists, or
doctors, working in a handful of asylums and sanitariums. If magic is more plentiful this skill would be even less known — it is primarily a nonmagical substitute for the hypnotism spell. When a character is curing madness, the DC of a Hypnosis skill check is equal to the DC of the subject's failed Madness save.
Madness and Campaign Style
To gain their full effect, Madness effects depend heavily on the players' willingness to
portray various forms of mental damage. This isn't a problem in a campaign using a great deal of personality and character development. many Madness effects run the risk of impairing the fun of the game if taken to the extreme. If Madness effects don't suit your style of play, it's best to simply remove them from the game. In this case, failed Madness saves only cause the effective ability decreases described above.
Hypnosis Therapy Modifiers
Modifier Condition
+2 The hypnotist can sense the subject's emotions through magical means (including hypnotism).
+1 The therapy takes places in a setting where the subject feels safe and comfortable.
+1 The hypnotist has the same alignment as the subject (disregarding Madness-induced alignment change).
+1 The hypnotist comes from a similar background as the subject (including homeland, social class, and character class).
The hypnotist can retry Hypnosis checks once per week (per subject) until the subject recovers.
This means that the aid of a successful hypnotist can give the insane character four chances to make recovery checks each month, rather than just one. A character cannot use Hypnosis on himself. A successful Hypnosis check garners two results. First, the subject can attempt an immediate recovery check to regain a single ability point, as detailed under Peace and Quiet, above. Second, each successful use of Hypnosis reduces the DC of the recovery check by 1 point. Example: A villager has failed a Madness save at DC 24. Sadly, the villager's total bonus to his Will save is only +2; it was +3, but he lost 2 points of Personality when he failed the original Madness save. Even if he rolls a 20 on his recovery check, the best he can do is a 22; without help, he'll never recover from his madness.
Fortunately, the skilled hypnotist Dr. Heinfroth takes the villager under his wing. In their first treatment session, the doctor makes a Hypnosis check against DC 24. With his total bonuses, he rolls a result of 26; a success. The villager's future recovery checks will now be only DC 23. The villager still can't make that, but another successful hypnosis session the next week would reduce the DC to 22, and so on — and the villager's chances for recovery would start to grow.
Sanitariums:
A few sanitariums are scattered across . While their purpose is to lift the affliction of derangement, more often they simply serve as prisons for the insane. Recovery in a sanitarium works just like hypnosis (in fact, that's the typical method of recovery used), but the sad truth is that a patient in a sanitarium is unlikely to receive the careful attention she requires. Each sanitarium offers a flat 1d8-5 (between -4 and +3) morale modifier to all recovery checks made in its care. As the modifier indicates, many patients in sanitariums would be better off locked in their nephews' attics. Patients in a sanitarium can make one recovery check per month, using the modifier above. Each success restores 1 point in one decreased ability score (player's choice) and reduces the DC of future recovery checks by 1 point. This bonus is cumulative.