Madness
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
Short-‐Term Madness
| gains a d100 | new character flaw from Effect (lasts 1d10 minutes) | the Indefinite |
|---|---|---|
| 01–20 | The character retreats becomes paralyzed. The character takes any | into his or her mind and effect ends if the damage. |
| 21–30 | The character becomes spends the duration weeping. | incapacitated and screaming, laughing, or |
| use his or her action and round to flee from the | movement each source of the fear. | |
| 41–50 | The character begins of normal speech or | babbling and is incapable spellcasting. |
| Column 1 | Column 2 |
|---|---|
| 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 Long-‐Term d100 | The character falls unconscious. Madness 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. |
Indefinite Madness
| d100 | Flaw (lasts until cured) | Column 3 |
|---|---|---|
| 01–15 | “Being drunk keeps me | sane.” |
| 16–25 | “I keep whatever I find.” | |
| 26–30 | “I try to become more know—adopting his or mannerisms, and name.” | like someone else I her style of dress, |
| 31–35 | “I must bend the truth, lie to be interesting to | exaggerate, or outright other people.” |
| 36–45 | “Achieving my goal is the to me, and I’ll ignore it.” | only thing of interest everything else to pursue |
| 46–50 | “I find it hard to care on around me.” | about anything that goes |
| 51–55 | “I don’t like the way people time.” | judge me all the |
| 56–70 | “I am the smartest, wisest, and most beautiful person | strongest, fastest, I know.” |
| 71–80 | “I am convinced that hunting me, and their go. I am sure they’re | powerful enemies are agents are everywhere I watching me all the time.” |
| 81–85 | “There’s only one person can see this special friend.” | I can trust. And only I |
| 86–95 | “I can’t take anything serious the situation, the | seriously. The more 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.