Sanity
Insanity is an affliction inflicted upon those who suffer from extraordinary physical, mental, or spiritual anguishes and trials. It can also be caused by exposure to particularly potent sources of horror, madness, or alien natures that the mind simply cannot withstand. Insanity is a mind-affecting effect.
Going Insane
Every time a creature is reduced to a score of 0 in Intelligence, Wisdom, or Charisma, there is a chance it goes insane. Either roll on the table below or select an insanity appropriate to the cause. The GM should make the victim's saving throw in secret — the player should not know the result or the type of insanity that might afflict them. Effects should play out naturally: some insanities take days or even months to trigger, while others (such as paranoia) are immediately obvious.
At the GM's option, a creature can risk going insane even when ability scores are unharmed. Long imprisonment might call for a save against agoraphobia or claustrophobia; repeated betrayal might trigger paranoia; possession might lead to psychosis upon exorcism.
Consider allowing the insanity spell to inflict 1 randomly determined insanity per 5 caster levels instead of permanent confusion. Bestow curse can inflict a single insanity; in that case the insanity is also a curse.
Curing Insanity
All insanities have a DC that represents their strength. This DC is both the Will save needed to resist contracting the insanity and the DC needed to recover. Recovering naturally is a lengthy process: once per week, the sufferer makes a Will save against the insanity's current DC. On success, the DC is reduced by their Charisma bonus (minimum 1). They continue to suffer the full effects until the DC reaches 0, at which point they are cured and the insanity vanishes completely.
| Lesser restoration | No effect on insanity. |
| Restoration | Reduces the current DC of one insanity by the caster's level. |
| Greater restoration, heal, limited wish, miracle, wish | Immediately cures the target of all insanity. |
Types of Insanity
When a creature goes insane, roll on the following table to determine what form of insanity strikes, or assign one to match the cause.
| d% | Insanity |
|---|---|
| 1–11 | Amnesia |
| 12–48 | Mania/Phobia |
| 49–68 | Multiple Personality Disorder |
| 69–78 | Paranoia |
| 79–84 | Psychosis |
| 85–100 | Schizophrenia |
The amnesiac cannot remember their name, skills, or past. They can build new memories, but all pre-amnesia memories are suppressed. Worse, they lose all class abilities, feats, and skill ranks for the duration. Base attack bonus, base saving throw bonuses, CMB, CMD, total XP, and hit points are retained. Levels gained while amnesiac grant only 1st-level abilities until the insanity is cured, at which point all abilities fully return.
A mania is an irrational obsession with a (usually inappropriate) object or situation. A phobia is an irrational fear of a (usually commonplace) object or situation. If directly confronted by the obsession (standard action), the character must make a Will save against the insanity's DC or become fascinated (mania) or frightened (phobia) for 1d6 rounds.
The number of additional personalities equals the insanity's DC ÷ 10 (round down, minimum 1). This number changes as the DC rises or falls. Every morning and each time rendered unconscious, the character makes a Will save against the DC; failure means a different personality takes over. Memories and skills remain, but personalities have no knowledge of each other and will deny — often violently — that the others exist.
The paranoid character is convinced that the world and all who dwell within it are out to get them. Paranoid characters are typically argumentative or introverted.
The victim is filled with hate for the world. They may suppress the psychosis for 1 day by making a Will save against the DC; otherwise they cannot help but plot the death and destruction of friends and enemies alike. The GM should assume control of the character whenever the psychosis is active.
The schizophrenic has lost their grip on reality and can no longer distinguish what is real from hallucination. This causes them to appear erratic and unpredictable. Each time they enter a stressful situation (such as combat), they must make a Will save against the insanity's DC or become confused for 1d6 rounds.