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-->-- '''[[WebAnimation/ZeroPunctuation Ben "Yahtzee" Croshaw]]''', [[http://www.escapistmagazine.com/videos/view/zero-punctuation/2092-Amnesia-The-Dark-Descent Amnesia: The Dark Descent review.]]

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-->-- '''[[WebAnimation/ZeroPunctuation Ben "Yahtzee" Croshaw]]''', [[http://www.escapistmagazine.com/videos/view/zero-punctuation/2092-Amnesia-The-Dark-Descent [[https://www.youtube.com/watch?v=IXuIZstyM7E Amnesia: The Dark Descent review.]]
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* ''VideoGame/{{Arknights}}'' has one in the roguelike Integrated Strategies game mode's third season "Mizuki & Caerula Arbor" in the form of Light meter, starting at 100 and drains when the player loses life seals or getting certain encounters. High Light gives the player a chance of receiving a helpful buff called Enlightenment on a die roll; at low Light they will instead receive Rejections, which are debuffs that can only be suppressed by sending the afflicted Operator away or using certain Collectibles. Low Light also raises the chance of the player being afflicted by "the Call of We Many", which carry random effects both beneficial and detrimental, and symbolizes [[spoiler:Mizuki succumbing to the influence of the Seaborn hive mind.]]
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[[folder:Real life]]

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[[folder:Real life]][[folder:RealLife]]
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[[caption-width-right:115:[[[[LetsPlay/{{Markiplier}} "Yeah. This is small brain time."]]]]

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[[caption-width-right:115:[[[[LetsPlay/{{Markiplier}} [[caption-width-right:115:[[LetsPlay/{{Markiplier}} "Yeah. This is small brain time."]]]]
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* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if its [[StopHelpingMe "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).

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* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if its [[StopHelpingMe [[AnnoyingVideoGameHelper "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).
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* In ''VideoGame/LobotomyCorporation'', each employee has a Sanity meter alongside their Health - and this being set in a facility where they have to work with barely-containable eldritch horrors, there are a number of ways they can lose their marbles: witnessing other people die, be dealt White or Black damage (White only targets sanity, Black targets both Sanity and Health) from escaped abnormalities, be assigned to work on an Abnormality they're too unskilled to handle (such as a Level 1 Agent dealing with any Abnormality above ZAYIN-Class) and other fun events. Going at 0 Sanity will trigger Panic into that employee, after which they're capable of a variety of reactions such as going run around screaming across the entire facility or go on a murderous rampage - the only reliable way to cure them of insanity is by hitting them with White-damage dealing Weapons, which will refill their sanity without harming their health.
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* Used in ''VideoGame/DreamsInTheWitchHouse2023'' where the PlayerCharacter, Walter Gilman's mental wellbeing can be gauged through his Sanity stat, which starts out at 10, but it increasingly lowers as he experiences more and more supernatural events and his Occult stat rises. Completing a task on his to-do-list or doing something comforting, like talking to one of his friends, allows him to occasionally replenish a little bit of Sanity.
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*''VideoGame/DCUniverseOnline'': In the Justice League Dark: Shattered Gotham raid, you have a 0 - 100 Madness meter that passively increases over time. The higher it gets, [[PowerBornOfMadness the more damage you deal]], but you also take increasing damage over time, and at 100, [[OneHitKill your whole team would get wiped instantly]]. Shazam's Wisdom of Solomon allows you to lower the Madness meter when needed.
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** A character's Humanity stat in the table game did much more than it did in Bloodlines. The Humanity stat for vampires is curious in that it did double duty as Sanity Meter and KarmaMeter, but does not stop you from picking up mental illnesses for other reasons. The Humanity Meter indicates what sort of wrong doing bothers a particular character, where a saintly person might feel guilty for selfish thoughts, most humans draw the line at theft, and a person low on the meter might be bothered by "Acts of Casual Perversion" or however it was phrased. Humanity kept the character from giving in to the monstrous barbarism ("Beast") of their undead state, but it didn't protect them from suffering OCD, schizophrenia, or other forms of mental illness. You could be a paranoid schizophrenic saint who had their "Beast" on quite a leash -- as a starting character.
** Low humanity vampires also found it excruciating to act during the day, had extreme difficulty in mimicking human physiology when it would help them (for example, warming your skin so a potential meal you were attempting to seduce wouldn't realize you were a corpse), and at Humanity Zero, a character would pretty much become a mad dog who had to be put down. Many princes of the Camarilla (the "less evil" faction) would put a vampire down before Humanity 0 just because they already became so violent, inhuman, and AxCrazy that they would threaten TheMasquerade just by existing.
** The game also featured alternative moral systems which were horrifying and outright evil by pretty much anyone's standards, but kept the Beast at bay. Such characters dove headfirst into being monsters to avoid becoming berserk, mad killing machines. For examples, one path says [[http://wiki.white-wolf.com/worldofdarkness/index.php?title=Path_of_Night be God's personal scourge]], another mandates you should [[http://wiki.white-wolf.com/worldofdarkness/index.php?title=Path_of_Power_and_the_Inner_Voice be a ruthless bastard]] with ChronicBackstabbingDisorder, and a third suggests you become an [[http://wiki.white-wolf.com/worldofdarkness/index.php?title=Path_of_Bones emotionless killer and student of death]]. Characters on these paths used very dark BlueAndOrangeMorality to remain less insane than the beast.

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** A character's Humanity stat in the table game did much more than it did in Bloodlines. The Humanity stat for vampires is curious in that it did double duty as Sanity Meter and KarmaMeter, but does not stop you from picking up mental illnesses for other reasons. The Humanity Meter indicates what sort of wrong doing bothers a particular character, where a saintly person might feel guilty for selfish thoughts, most humans draw the line at theft, and a person low on the meter might be fine with PragmaticVillainy but still be bothered by "Acts of Casual Perversion" or however it was phrased. Humanity kept the character from giving in to the monstrous barbarism ("Beast") of their undead state, but it didn't protect them from suffering OCD, schizophrenia, or other forms of mental illness. You could be a paranoid schizophrenic saint who had their "Beast" on quite a leash -- leash-- as a starting character.
** Low humanity vampires also found it excruciating to act during the day, had extreme difficulty in mimicking human physiology when it would help them (for example, warming your skin so a potential meal you were attempting to seduce wouldn't realize you were a corpse), and at Humanity Zero, a character would pretty much become a mad dog who had to be put down. Many princes of the Camarilla (the "less evil" faction) would put a vampire down before Humanity 0 just because they had already became become so violent, inhuman, and AxCrazy that they would threaten TheMasquerade just by existing.
** The game also featured alternative moral systems which were horrifying and outright evil by pretty much anyone's standards, but kept the Beast at bay. Such characters dove headfirst into being monsters to avoid becoming berserk, mad killing machines. For examples, one path says [[http://wiki.white-wolf.com/worldofdarkness/index.php?title=Path_of_Night be God's personal scourge]], another mandates you should [[http://wiki.white-wolf.com/worldofdarkness/index.php?title=Path_of_Power_and_the_Inner_Voice be a ruthless bastard]] with ChronicBackstabbingDisorder, and a third suggests you become an [[http://wiki.white-wolf.com/worldofdarkness/index.php?title=Path_of_Bones emotionless killer and student of death]]. Characters on these paths used very dark BlueAndOrangeMorality to remain less insane than the beast.Beast.



** In ''TabletopGame/WarhammerFantasyRoleplay'' you need to make a willpower roll for every Insanity Point you gain above 5; failure on this roll or reaching 12 insanity points resets your points to 0 and gives you a major derangement that will cripple or render your character unplayable right off the bat. On average, a bad roller will get two-three insanity points per session; double that estimate for a magic user. Unless you have a Gold Wizard, a very lucky brain surgeon or a Priest of Shalliya amongst your list of friends, insanities, and insanity points are incurable.

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** In ''TabletopGame/WarhammerFantasyRoleplay'' you need to make a willpower roll for every Insanity Point you gain above 5; failure on this roll or reaching 12 insanity points resets your points to 0 and gives you a major derangement that will cripple or render your character unplayable right off the bat. On average, a bad roller will get two-three insanity points per session; double that estimate for a magic user. Unless you have a Gold Wizard, a very lucky brain surgeon or a Priest of Shalliya amongst your list of friends, insanities, and insanity points and derangements are incurable.



** Other games in the 40K RPG line handle insanity as well as [[TheCorruption Corruption Points]] in different ways. ''TabletopGame/{{Deathwatch}}'' Space Marines who gain too much Insanity suffer from varying levels of the "Primarch's Curse", which is dependent on their chapter; they're immune to effects from Corruption (which tends to lead to madness and mutation) unless they hit 100 points at which point they're removed from play permanently. ''TabletopGame/BlackCrusade'' characters are immune to Insanity (they don't gain points, but certain fears can cause them to get disorders on bad rolls), since they serve the [[EldritchAbomination Gods of Chaos]] - they are considered to have already reached the end of the 100 point score of the other games and [[CrazySane come around again]]. ''TabletopGame/OnlyWar'' and ''TabletopGame/RogueTrader'' treat it similarly to Dark Heresy, although Rogue Trader expansions ''Into the Storm'' and ''The Soul Reaver'' gives options for certain Xenos characters. Both the Orks and Dark Eldar are effectively immune to insanity, not because of innate wholesomeness but because they're already [[BlueAndOrangeMorality inherently insane by human standards]], and there's no functional difference between "Normal Ork" and "Extra Crazy Ork".

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** Other games in the 40K RPG line handle insanity as well as [[TheCorruption Corruption Points]] in different ways. ''TabletopGame/{{Deathwatch}}'' Space Marines who gain too much Insanity suffer from varying levels of the "Primarch's Curse", which is dependent on their chapter; they're immune to effects from Corruption (which tends to lead to madness and mutation) unless they hit 100 points at which point they're removed from play permanently. ''TabletopGame/BlackCrusade'' characters are immune to Insanity (they don't gain points, but certain fears can cause them to get disorders on bad rolls), since they serve the [[EldritchAbomination Gods of Chaos]] - they are considered to have already reached the end of the 100 point score of the other games and [[CrazySane come around again]]. ''TabletopGame/OnlyWar'' and ''TabletopGame/RogueTrader'' treat it similarly to Dark Heresy, although Rogue Trader expansions ''Into the Storm'' and ''The Soul Reaver'' gives give options for certain Xenos characters. Both the Orks and Dark Eldar are effectively immune to insanity, not because of innate wholesomeness but because they're already [[BlueAndOrangeMorality inherently insane by human standards]], and there's no functional difference between "Normal Ork" and "Extra Crazy Ork".
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* The Madness Meters in ''TabletopGame/UnknownArmies''. There are five; Isolation, Helplessness, Violence, Self, and The Unnatural. Depending on how well you roll when confronted with triggers, you either fill them with a Failed notch, or a Hardened notch. The more Failed notches you gather, the more likely you are to break down crying when you experience a trigger; the more Hardened notches you gather, the more immune you become to the trigger (to the point where a character with all Hardened notches in their Violence meter becomes a sociopath who doesn't really see the problem with carving a guy's face off with a potato peeler, and is only vaguely aware that others might not feel like he does).

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* The Madness Meters in ''TabletopGame/UnknownArmies''. There are five; Isolation, Helplessness, Violence, Self, and The Unnatural. Depending on how well you roll when confronted with triggers, you either fill them with either a Failed notch, notch or a Hardened notch. The more Failed notches you gather, the more likely you are to break down crying when you experience a trigger; the more Hardened notches you gather, the more immune you become to the trigger (to the point where a character with all Hardened notches in their Violence meter becomes a sociopath who doesn't really see the problem with carving a guy's face off with a potato peeler, and is only vaguely aware that others might not feel like he does).
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* ''TabletopGame/DontRestYourHead'' possesses a Madness pool of dices. Usually up to 6 can be used at any time (and they are required to use the [[PowerBornOfMadness Madness Talents]]); the more are used, the more likely you are to spend a "fight" or a "flight" reaction. If none of these are available, the character ''snaps''. When it comes to its senses, the reactions are back, but one Discipline dice gets replaced by a Madness dice. Which allows more powerful uses of one's powers, but also makes it more likely to snap again. And if all Discipline gets consumed, [[AndThenJohnWasAZombie well...]]

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* ''TabletopGame/DontRestYourHead'' possesses has a Madness pool of dices.dice pool. Usually up to 6 can be used at any time (and they are required to use the [[PowerBornOfMadness Madness Talents]]); the more are used, the more likely you are to spend a "fight" or a "flight" reaction. If none of these are available, the character ''snaps''. When it comes to its senses, the reactions are back, but one Discipline dice die gets replaced by a Madness dice.die. Which allows more powerful uses of one's powers, but also makes it more likely to snap again. And if all Discipline gets consumed, [[AndThenJohnWasAZombie well...]]
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* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if it's [[StopHelpingMe "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).

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* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if it's its [[StopHelpingMe "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).

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* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if it's [[StopHelpingMe "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).



* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if it's [[StopHelpingMe "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).
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* Recent editions of ''TabletopGame/{{Paranoia}}'' elevate Moxie from a mere "figure out unfamiliar stuff in a hurry" stat to this trope. At zero Moxie, you completely Lose It and go berserk until stopped (usually via termination). You can stress yourself out voluntarily for a short-term sdvantage, or lose a point automatically when Friend Computer actively pays attention to you (because even if it's [[StopHelpingMe "help"]] is actually helpful for once, you're still waiting for the other shoe to drop, if not now then later).
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* ''TabletopGame/BladesInTheDark'' has Trauma, which mounts up over time. When a player character hits four Trauma, five with certain upgrades, they're no longer functional enough to go a-thieving and has to retire; of course, "retirement" can involve TakingTheHeat to get the WantedLevel down.

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* ''TabletopGame/BladesInTheDark'' has Trauma, which mounts up over time. When a player character hits four Trauma, five with certain upgrades, they're no longer functional enough to go a-thieving and has to retire; of course, "retirement" retire. Said retirement" can involve TakingTheHeat to get for the WantedLevel down.crew, reducing their [[WantedMeter Heat]].
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* ''VideoGame/FiveNightsAtFreddys''

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* ''VideoGame/FiveNightsAtFreddys'' ''VideoGame/FiveNightsAtFreddys'':
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* ''VideoGame/TheOutlastTrials'': The Pusher, one of the game's Ex-Pops, will spray you with gas from his mask. This gas will deplete your meter, then eventually you'll start hallucinating Skinner Man, one of the more challenging enemies to evade, since he can see you anywhere you go. And don't think that it being in your mind doesn't mean it can't hurt you. Unless you find an antidote for the temporary psychosis, don't stop running while you recover your sanity.
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* In the horror game ''VideoGame/KnockKnock'', after you reach the final levels, the game gets a massive [[DifficultySpike difficulty spike]] and gives you a Sanity Meter, which drains while you're in the woods and if you are touched by the Guests. What makes it specially bad is that, by the ending, if the bar is very small or empty (there are no ways to refill it), you will get a GameOver the instant you attempt to leave the house, preventing you from finishing the game and having to start over.

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* In the horror game ''VideoGame/KnockKnock'', after you reach the final levels, the game gets a massive [[DifficultySpike difficulty spike]] spike and gives you a Sanity Meter, which drains while you're in the woods and if you are touched by the Guests. What makes it specially bad is that, by the ending, if the bar is very small or empty (there are no ways to refill it), you will get a GameOver the instant you attempt to leave the house, preventing you from finishing the game and having to start over.
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* ''VideoGame/GarfieldsScaryScavengerHunt'': Garfield has a "Scare-o-Meter" that increases whenever he gets scared by one of the monsters or other creepy sights in the mansion. When it reaches its maximum, he panics and runs out of the mansion, ending the game.
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* The Creator/AdultSwim flash game ''Schizo-Phrenzy'' has the sanity meter count as health. As it decreases, it increases enemy generation rate, flashes a random image, and eventually leads to [[CriticalAnnoyance yodeling]]. Up to five pills can be stocked to restore the meter.
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* ''VideoGame/AmnesiaTheDarkDescent'' has one of these, in much the same vein as ''TabletopGame/CallOfCthulhu''. With the levels going from "Crystal clear" to "A slight headache" to "Head is pounding and hands are shaking" to [[NothingIsScarier "..."]], it drains whenever you either look directly at a monster, linger in the dark, or encounter something horrific. Regarding the InterfaceScrew, it can range from a drunken haze to laying down and dragging yourself along while insects crawl along your field of vision, and paintings become grotesque. Once it's low enough, the monsters will chase after you. The only way to restore it is to solve puzzles and make progress, whereupon the screen is taken by a lilac haze and you hear a noise similar to a sigh of relief; there is a "Sanity Potion" item in the game's files, but it was DummiedOut during development, and it can only be found in [[GameMod custom stories]].

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* ''VideoGame/AmnesiaTheDarkDescent'' has one of these, in much a sanity system tied to the same vein as ''TabletopGame/CallOfCthulhu''.fear Daniel is experiencing. With the levels going from "Crystal clear" to "A slight headache" to "Head is pounding and hands are shaking" to [[NothingIsScarier "..."]], it drains whenever you either look directly at a monster, [[PrimalFear linger in the dark, dark]], or encounter something horrific. Regarding the InterfaceScrew, it can range from a drunken haze to having a FreakOut, laying down and dragging yourself along in a panic while insects crawl along your field of vision, and paintings become becoming grotesque. Once it's low enough, the monsters will be alerted and chase after you.you even if you don't mess up and make noise or reveal yourself. The only way to restore it is to solve puzzles and make progress, whereupon the screen is taken by a lilac haze and you hear a noise similar to a sigh of relief; there is a "Sanity Potion" item in the game's files, but it was DummiedOut during development, and it can only be found in [[GameMod custom stories]].
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** Fan game ''TabletopGame/GeniusTheTransgression'' has Obligation, which is a hybrid sanity meter, karma meter, and ComesGreatResponsibility. The more the Genius violates social norms and/or dips into doing very nasty things with MadScience, the further they lose themselves to their [[ScienceRelatedMemeticDisorder Inspiration]]. If they bottom out, everything they are is burned away by Inspiration, leaving them as one of the [[TheUnfettered Illuminated]], who care only for whatever mad theories they have conceived, to the point they would willingly rip the heart out of a child if they felt it would advance their work. This is actually the ''rarer'' of the two ways to become Illuminated (Geniuses keep tabs on each other and are quite willing to ShootTheDog if necessary); a Genius who delves too far into their personal madness risks becoming an Unmada, and if an Unmada does the same thing and screws up they become Illuminated.
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* In ''VideoGame/DarkestDungeon'', the heroes' stress bars act as secondary health meters: when a hero's stress reaches 100, they go insane. Typically, this results in an [[HeroicBSOD Affliction]], one of several mental disorders, which can cause them to do erratic and harmful things like skipping a turn, refuse support abilities (''especially'' healing) used on them[[note]]especially bad while camping, as the time units for respite activities are wasted[[/note]], stressing out their comrades or even outright attacking them. If they become stressed over the 200 threshold, they'll scream and have a Heart Attack, that either [[HPToOne drops them straight into]] [[LastChanceHitPoint Death's Door]], or if they are already there, they'll flat out die; unlike dying from enemy attacks, there's NoSavingThrow. However, there's a chance their insanity is the rare and positive [[HeroicWillpower Virtuous]] type instead, reducing stress or bolstering either themselves or their teammates; additionally, they gain a shield against Heart Attacks (a Virtuous hero that reaches 200 stress loses their Virtue and all of their stress instead). The one exception to that is the Flagellant, a class that is exempt from the resolve check roulette – he always goes Rapturous, an affliction exclusive to him that makes him act slightly erratically and swaps his ability to dodge for sheer attack power. It's a valid strategy to intentionally drive him insane solely for the double-edged affliction.

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* In ''VideoGame/DarkestDungeon'', the heroes' stress bars act as secondary health meters: when a hero's stress reaches 100, they go insane. Typically, this results in an [[HeroicBSOD Affliction]], one of several mental disorders, which can cause them to do erratic and harmful things like skipping a turn, refuse support abilities (''especially'' healing) used on them[[note]]especially bad while camping, as the time units for respite activities are wasted[[/note]], stressing out their comrades or even outright attacking them. If they become stressed over the 200 threshold, they'll scream and have a Heart Attack, that either [[HPToOne [[HPTo1 drops them straight into]] [[LastChanceHitPoint Death's Door]], or if they are already there, they'll flat out die; unlike dying from enemy attacks, there's NoSavingThrow. However, there's a chance their insanity is the rare and positive [[HeroicWillpower Virtuous]] type instead, reducing stress or bolstering either themselves or their teammates; additionally, they gain a shield against Heart Attacks (a Virtuous hero that reaches 200 stress loses their Virtue and all of their stress instead). The one exception to that is the Flagellant, a class that is exempt from the resolve check roulette – he always goes Rapturous, an affliction exclusive to him that makes him act slightly erratically and swaps his ability to dodge for sheer attack power. It's a valid strategy to intentionally drive him insane solely for the double-edged affliction.

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More indentation and other touch-ups.


* ''VideoGame/EternalDarkness'' popularized the Sanity Meter in video games. Encountering monsters drains Sanity, and as the meter decreases, you experience hallucinations, from [[DutchAngle a canted view]], unnerving sounds, or harmless changes to the scenery, to more extreme cases like your character's head falling off and reciting Theatre/{{Hamlet}}, a healing spell backfiring and "killing" your character, or even {{Interface Screw}}s like the game switching to another video imput, lowering the volume, or "deleting" your game instead of saving it. You can recover big doses of Sanity with the right magick, or smaller amounts by performing {{Finishing Move}}s on downed monsters.

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* ''VideoGame/EternalDarkness'' popularized the Sanity Meter in video games. Encountering monsters drains Sanity, and as the meter decreases, you experience hallucinations, from [[DutchAngle a canted view]], unnerving sounds, or harmless changes to the scenery, to more extreme cases like your character's head falling off and reciting Theatre/{{Hamlet}}, a healing spell backfiring and "killing" your character, or even {{Interface Screw}}s like the game switching to another video imput, input, lowering the volume, or "deleting" your game instead of saving it. Aside from all of these "flavor" effects, if the character's sanity is at zero, any further sanity loss will instead drain health. You can recover restore big doses of Sanity with the right magick, magicks and items, or smaller amounts by performing {{Finishing Move}}s on downed monsters.



* The player character of ''VideoGame/FiveNightsAtFreddys'' can hallucinate, causing messages and extreme close-ups of enemies to flicker across the screen, freaky sounds to play, posters to change, and [[spoiler:allow Golden Freddy to spawn in]]. Notably, there's nothing the player can do to prevent sanity loss: the protagonist hallucinates more and more as the week goes on, no matter how well you play.
* This returns with a vengeance in ''VideoGame/FiveNightsAtFreddys3'' where hallucinations of the past 2 game's antagonists appear both in your cameras and your office. Staring at them for more than a glance will prompt them to jumpscare you, disabling your ventilation and other systems, causing you to briefly blackout until it's fixed. In a game where having a visual of your enemy is critical for your survival, this is a huge issue.

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* ''VideoGame/FiveNightsAtFreddys''
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The player character of ''VideoGame/FiveNightsAtFreddys'' PlayerCharacter can hallucinate, causing messages and extreme close-ups of enemies to flicker across the screen, freaky sounds to play, posters to change, and [[spoiler:allow Golden Freddy to spawn in]]. Notably, there's nothing the player can do to prevent sanity loss: the protagonist hallucinates more and more as the week goes on, no matter how well you play.
* ** This returns with a vengeance in ''VideoGame/FiveNightsAtFreddys3'' where hallucinations of the past 2 game's two games' antagonists appear both in your cameras and your office. Staring at them for more than a glance will prompt them to jumpscare you, disabling your ventilation and other systems, causing you to briefly blackout until it's fixed. In a game where having a visual of your enemy is critical for your survival, this is a huge issue.



* For an incredibly early (perhaps the earliest?) example, check out Domark's 1985 ''Videogame/FridayThe13thTheComputerGame'' on the Commodore 64, Amstrad and Spectrum (it's nothing like [[{{VideoGame/Friday the 13th}} the NES version]]). The game has a sanity/fear meter that raises as the game goes on. It's represented as a kid's head, with the hair starting to stand on end as you get more frightened. If the meter maxes out, you die of fright... this almost never happens in-game, but it does increase the chances of seeing hallucinations (a pile of skulls covered in blood, someone with a machete through their head, etc) accompanied by a blood-curdling scream. Surprisingly effective for 16-colour graphics!

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* For an incredibly early (perhaps the earliest?) example, check out Domark's 1985 ''Videogame/FridayThe13thTheComputerGame'' on the Commodore 64, Amstrad and Spectrum (it's nothing like [[{{VideoGame/Friday the 13th}} the NES version]]). The game version]]) has a sanity/fear meter that raises as the game goes on. It's represented as a kid's head, with the hair starting to stand on end as you get more frightened. If the meter maxes out, you die of fright... this fright. This almost never happens in-game, but it does increase the chances of seeing hallucinations (a pile of skulls covered in blood, someone with a machete through their head, etc) accompanied by a blood-curdling scream. Surprisingly effective for 16-colour graphics!
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* The ''VisualNovel/ItLives'' series features one of these in the form of a "Nerve Score", which ranges from 0 to 100. Making the right choices, hanging out with friends, acquiring weapons, and so on raises your Nerve Score, while encountering monsters, making incorrect choices, and getting injured lowers it. The main character and their friends all have Nerve Scores, and anyone with a Nerve Score has the potential to die if it's too low. In the first game, the Nerve Score's main function is determining whether a character survives the FinalBattle. In the second game, each character has a "moment of truth", whereupon their success or failure is dependent on their nerve score. In Chapter 15, the group's Nerve Scores are totalled up, and if the value is too low, the person with the lowest nerve score ([[PlotArmor excluding the main character]]) will die. In the final chapter, [[spoiler: the main character is thrust into a live-or-die situation where their Nerve Score determines how much time they have to escape a DeathTrap (if their Nerve Score is ''really'' low, they aren't given a chance to escape and they will automatically die)]].
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* ''VideoGame/{{Kuon}}'': Although it's less deep then some. As the characters exert themselves or are thrust into particularly haunted areas, the screen around the player starts to swirl, giving the sense that the characters are out of breath. This can be fixed through meditation, although if it happens in combat then you are in trouble.

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* ''VideoGame/{{Kuon}}'': Although it's less deep then some. As than some; as the characters exert themselves or are thrust into particularly haunted areas, the screen around the player starts to swirl, giving the sense that the characters are out of breath. This can be fixed through meditation, although if it happens in combat then you are in trouble.
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* In ''VideoGame/WeHappyFew'', the player has a meter measuring how much of the Joy drug is in their system. As the meter fills things look nicer, brighter and cheerier. If it fills completely then they’ll suffer from a “Joy Overdose” which makes them act like a batshit loon who thinks they’re puking up rainbows and butterflies. It makes it much harder to act stealthily, and makes all your actions slower and weaker. Or alternatively if you REALLY overdose on joy, then you can suffer from [[FreakOut “Memory Loss”]] where everything turns gray and black, everyone has red eyes and demon voices, and your character [[OhCrap realizes just how much joy they’ve been taking.]] Actions are even slower,and you’re much more suspicious in this state.

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* In ''VideoGame/WeHappyFew'', the player has a meter measuring how much of the Joy drug is in their system. As the meter fills things look nicer, brighter and cheerier. If it fills completely then they’ll suffer from a “Joy Overdose” which makes them act like a batshit loon who thinks they’re puking up rainbows and butterflies. It makes it much harder to act stealthily, and makes all your actions slower and weaker. Or alternatively if you REALLY overdose on joy, then you can suffer from [[FreakOut “Memory Loss”]] where everything turns gray and black, everyone has red eyes and demon voices, and your character [[OhCrap realizes just how much joy they’ve been taking.]] Actions are even slower,and slower, and you’re much more suspicious in this state.
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* In ''VideoGame/SixtySeconds'', each family member can lose sanity from a variety of factors such as being left alone for too long (so no, you can't conserve food and water by not bringing any family members), not having anything to distract them from the day-to-day tedium, or [[VideoGameCrueltyPunishment doing immoral actions like raiding other people's shelters]]. Losing too much sanity will cause them to start [[MadnessMakeover looking crazed]] and potentially destroying random items in the shelter, and letting them stay in that state for too long will cause them to run out of the shelter and never be seen again.

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* In ''VideoGame/SixtySeconds'', each family member can lose sanity from a variety of factors such as [[GoMadFromTheIsolation being left alone for too long long]] (so no, you can't conserve food and water by not bringing any family members), not having anything to distract them from the day-to-day tedium, or [[VideoGameCrueltyPunishment doing immoral actions like raiding other people's shelters]]. Losing too much sanity will cause them to start [[MadnessMakeover looking crazed]] and potentially destroying random items in the shelter, and letting them stay in that state for too long will cause them to run out of the shelter and never be seen again.
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* Like the above game, ''VisualNovel/ThePriceOfFlesh'' has a sanity meter, and it's an especially critical component to survival in Mason's route.

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