Sanity is the natural mental state of ordinary life. Normal mental balance is endangered when characters confront the horrors of the Otherworld - their entities and activities are shocking, unnatural, and bewildering. Such encounters cause characters to lose Sanity points, which in turn risks temporary, indefinite, or permanent insanity. Mental stability and lost Sanity points may be restored, up to a point, but mental scars may remain.

Insanity occurs if too many Sanity points are lost in too short a time. Insanity does not necessarily occur if Sanity points are low, but a lower Sanity point total makes some forms of insanity more likely to occur after an emotional shock occurs. The character's Sanity may be regained after a few minutes, recovered after a few months, or lost forever.

A character may regain Sanity points, and even increase her Sanity point maximum. However, an increase in a character's Forbidden Lore skill always lowers her potential maximum Sanity by an equal amount.

Loss of Sanity

Conflict, abuse, or any other strong personal experience inflicts emotional scars. To emphasize certain ideas he had concerning fear, the unknown, and humanity's lowly place in the scheme of things, Lovecraft posited brand new terrors for us. He suggested that the laws of space and time that we believe to be universal and immutable are only locally valid, and only partly true.

Beyond our ken lie infinities where greater realities hold sway. Outside our perception, alien powers and races wait with hostility, or at best, cosmic indifference. Some encroach on our world. The true universe is one with no joy or comfort. It is driven by mind-bending forces to which our existence holds no significance, and titanic struggles in which our desires and needs matter not at all. Human insanity confirms these terrible revelations, and is often caused by them. Through madness, we glimpse the dark and bloody truths at the heart of the universe.

Sanity is ordinarily lost in a few specific ways.

Learning the Truth

Knowledge is dangerous, and none more dangerous than knowledge of the Otherworld - the true face of reality in the universe. No amount of psychotherapy or rest can remove the danger of self-transformation from such knowledge.

Using Spells

Magic relies on the physics of the true universe. By learning and casting spells, characters visualize the unimaginable, warping their minds to follow alien ways of thought. These wound the mind. Such traumas are ones for which the casters volunteer, it is true, but they are shocks all the same.

Reading Forbidden Tomes

Forbidden tomes add ranks to an investigator's Forbidden Lore skill and teach spells. Studying and comprehending forbidden tomes causes all that we know to become like shadows. The burning power of a greater reality seizes the soul. Whether we try to retreat from the experience or hunger greedily for more, it destroys our confidence in what we once believed, opening us up to the all-encompassing truths of the Outside.

Encountering the Unimaginable

When people perceive the creatures and entities of the Otherworld, it costs them some portion of their minds, as such creatures are intrinsically discomforting and repellent. We never lose awareness of their slimy, fetid, alien nature, often characterized as "obscene" or "blasphemous." This instinctive reaction is part and parcel of every human being. In this category, we can include supernatural events or agents not always recognized as specifically attached to the Otherworld, such as hauntings, zombies, vampires, curses, and so on.

Severe Shocks

Mundane shocks can also cost Sanity. This includes witnessing untimely or violent death, experiencing personal mutilation, loss of social position, treachery, the failure of love, or whatever else the Gamemaster decides is sufficiently extreme.

Sanity Points

Sanity points (SAN) measure the stability of a character's mind. This trait provides a way to display the sanity inherent in a character, the most stability a character can ever have, and the current level of sane rationality that a character still preserves, even after numerous shocks and horrid revelations.

Sanity is measured in three ways: starting Sanity (5 times the character's Wisdom score), maximum Sanity (99 minus Forbidden Lore ranks), and current Sanity.

Starting Sanity

Starting Sanity equals a character's Wisdom score multiplied by 5. This score represents a starting character's current Sanity points, as well as the upper limit of Sanity that can be restored by the Psychoanalysis skill. After creation, a character's current Sanity score often fluctuates considerably and might never again match starting Sanity. A change in a character's Wisdom score changes the starting Sanity score in regard to what Psychoanalysis can restore. Current Sanity, however, does not change if Wisdom rises or falls.

Maximum Sanity

The Forbidden Lore skill simulates character comprehension of aspects of the Otherworld. Once gained, this horrible knowledge is never forgotten, and the character consequently surrenders mental equilibrium. A character's Sanity weakens as his comprehension of the Otherworld increases. Such is the way of the universe.

A character's current Sanity can never be higher than 99 minus the modifier the character has in the Forbidden Lore skill. This number is the character's maximum Sanity.

Current Sanity

A character's current Sanity points fluctuate almost as often (and sometimes much more often) than hit points.

Making a Sanity Check

When a character encounters a gruesome, unnatural, or supernatural situation, the GM may require a player to make a Sanity check with a percentile dice (d%). The check succeeds of the result is equal to or less than the character's current Sanity.

On a successful check, the character either loses no Sanity or only loses a minimal amount. Potential Sanity loss is usually shown as two numbers or dice rolls separated by a slash, such as 0/1d4. The number before the slash indicates the number of Sanity points lost if the Sanity check succeeds (in this case, none); the number after the slash indicates the number of Sanity points lost if the Sanity check fails (in this case, between 1 and 4 points).

A character's current Sanity is also at risk when the character reads certain books, learns the spells contained within, and attempts to cast them. These losses are usually automatic (no Sanity check is involved) – the character who chooses to undertake that activity forfeits the required Sanity points.

For the most part, a new Sanity-shaking confrontation requires a new Sanity check. However, the GM always gets to decide when characters make Sanity checks. Confronting several horribly mangled corpses at one time or in rapid succession may call for just one Sanity check, while the same encounters at intervals of several game hours may require separate checks.

Going Insane

Losing more than a few Sanity points may also cause the character to go insane, as described below. If a character's Sanity points drop to 0, she begins the quick slide into permanent insanity. Each round, the character loses another point of Sanity. Once a character reaches -10 Sanity points, she is hopelessly, incurably insane. See the Psychoanalysis skill for information on stabilizing a character on the threshold of permanent insanity.

Getting Used to Awfulness

Never underestimate the ability of the human mind to adapt, even to the most horrific experiences. Reading and rereading the same bit of disturbing text or seeing the same horrible image over and over eventually provokes no further loss. Within a reasonable interval of play, usually a single session of the game, characters should not lose more Sanity points for seeing monsters of a particular sort than the maximum possible points a character could lose for seeing one such monster. For instance, the Sanity loss for seeing a single zombie is 0/1d6. Thus, in the same game day or in the same play session, no character should lose more than 6 Sanity points total for seeing any number of zombies. Keep in mind that the interpretation of “reasonable interval” must vary by GM and situation. When it feels right, the GM should rule that the horror is renewed and points must be lost again.

Learning or casting spells never becomes a normal thing to do. No matter how many times a character casts a spell, no matter what the time interval between castings may be, the Sanity loss is always the same. This is true of anything that a character does willingly. For example, if brutally murdering a friend costs 2/2d10 Sanity, this loss is incurred each time, even if the character loses the maximum possible points after the first or even the second murder.


Character insanity is induced by a swift succession of shocking experiences or ghastly revelations, events usually connected with the Otherworld. The type of insanity incurred depends on the proportion of Sanity points lost. The duration of insanity varies as well.
Horrifying encounters can result in three states of mental unbalance. Two of them, temporary and indefinite insanity, can be cured. The third, permanent insanity, results when a character's Sanity is reduced to -10 or below and cannot be cured.

Temporary Insanity

Whenever a character loses Sanity points equal to one-half her Wisdom score from a single roll, she has suffered enough shock that the GM must ask for a Sanity check. If the check fails, then the character realizes the full significance of what she saw or experienced and goes temporarily insane. If the check succeeds, the character does not go mad, but in consequence, she may not clearly remember what she experienced – a trick the mind plays to protect itself.

Temporary insanity might last for a few minutes or a few days. Perhaps the character acquires a phobia or fetish befitting the situation, faints, becomes hysterical, or suffers nervous twitches, but she can still respond well enough to run away or hide.
The character remains in this state for the length of time rolled by the GM. The GM must describe the insanity so that the player can roleplay it accordingly. Anyone can create new insanities as appropriate – though for the shortest extents, simple characterization will do, such as “lies on the ground and twitches,” “runs shrieking into the night,” or “drools and squeaks like a baby.” The character is overwhelmed by fear or horror, incapacitated, and then recovers quickly.

Successful application of the Psychoanalysis skill or Treat Injury skill may alleviate or erase temporary insanity.

Temporary insanity concludes when the duration of game time rolled has elapsed, or when the GM feels the end to be appropriate.
The intent of temporary insanity is forcing a character's behavior to noticeably change for a limited time. Whether this means that the character is babbling in some corner, running away in a panic, or attacking an Elder God with a can-opener is up to the creativity and inspiration of the player and the GM.

After the temporary insanity ends, traces or even profound evidence of the experience should remain. No reason exists that a phobia, for instance, should depart from someone's mind as quickly as a train pulls out of a station. What remains behind after the brief episode of insanity should exert a pervasive influence on the character. The character may still be a bit batty, but her conscious mind once again runs the show.

Indefinite Insanity

If a character loses 20% (one-fifth) or more of her current Sanity points in 1 hour, she goes indefinitely insane. The GM judges when the impact of events calls for such a measure. Some GM's never apply the concept to more than the result of a single die roll, since this state can remove characters from play for extended periods. Beginning immediately, indefinite insanity lasts 1d6 game months (or as the GM indicates). Symptoms of indefinite insanity may not be immediately apparent. This may give the GM additional time to decide what the effects of the bout of insanity might be.

The state of indefinite insanity is encompassing and incapacitating. For instance, a schizophrenic may be able to walk the streets babbling and gesticulating, find rudimentary shelter, and be able to beg for enough food to survive, but most of the business of the mind has departed into itself: She cannot fully interact with friends, family, and acquaintances. Conversation, cooperation, and personal regard have vanished.

It is possible for characters with indefinite insanity to continue to be played as active characters, depending on the form their madness takes. The character may still be able to stumble madly through the rest of the adventure. However, with her weakened grasp on reality, she is a danger to herself and others.

For the most part, indefinitely insane characters should be removed from active play until they recover. At the GM's discretion, that player might be able to use a temporary character until the end of the story. Whether this “stand-in” character is an incidental NPC in the adventure, the same level as the rest of the group, one or two levels below the rest of the characters, or even a 1st level character is up to the GM.

If a character goes mad near the end of an adventure, the GM may decide to set the beginning of the next adventure after the insane character recovers.

The indefinitely insane are in limbo, unable to help themselves or others. The psychoanalysis skill can be used to restore Sanity points during this period, but the underlying insanity remains.

After recovery, the victim retains definite traces of madness. For example, he might hesitate to step out onto a bridge for fear that “gravity will get him,” even though he knows rationally that the bridge will not collapse. The character is in control, but the experience has changed him, perhaps forever.

Gaining the Forbidden Lore Skill

A character's first instance of Otherworld-related insanity bestows 2 ranks of the Forbidden Lore skill, thereby lowering maximum Sanity by 2 points. Each time a character fails a Sanity check and endures another Realm-related episode of insanity (that is, temporary or indefinite insanity), he gains an additional rank in Forbidden Lore. No maximum rank exists for a character's Forbidden Lore skill.

For example, Claire has 1 rank of Forbidden Lore after reading a strange manuscript. She then steps outside, sees a nightgaunt fly overhead, and goes indefinitely insane, her raving mind failing to understand the unearthly manifestation. Since she has never gone mad before, her player adds two ranks of Forbidden Lore to Claire's character sheet. Now Claire's maximum Sanity is 96 (99 minus 3 ranks of Forbidden Lore).

Permanent Insanity

Characters who reach -10 Sanity go permanently insane. The character becomes an NPC under the control of the GM. A character with -10 Sanity points may be reduced to a raving lunatic or may be outwardly indistinguishable from a normal person, but inwardly corrupted by the pursuit of knowledge and power. Some of the most dangerous cultists in the world are characters who have gone completely insane, been corrupted by the Otherworld, and “gone over to the other side.”

A character who has gone permanently insane can never be normal again. She is forever lost in her own world. This need not mean a lifetime in a padded cell, merely that the character has retreated so far from reality that sanity can never be restored. She might be able to lead, within restricted bounds, a more or less normal life if kept away from the things that trigger strong responses in her individual case. Yet a relapse may come quickly. Her calm façade can be destroyed in seconds if her fragile equilibrium is disturbed by even the smallest reminder of whatever it was that drove her mad.

Recovering Sanity

A character's Sanity score can increase during the events of a campaign. Although a character's Sanity score can never exceed 99 minus her Forbidden Lore skill modifier, her current Sanity and maximum Sanity can exceed starting Sanity.

Mental Therapy

To give useful therapy, the therapist must have the Psychoanalysis skill. Intensive psychoanalysis can return Sanity points to a troubled character. However, Sanity points restored can never exceed the patient's starting Sanity. Psychoanalysis can restore but never improve the character. A character can have only one psychoanalyst at a time.

Psychoanalysis can also be used to help a character snap out of temporary insanity. It does not speed recovery from indefinite insanity, but it can strengthen the character by adding Sanity points.

Recovery from indefinite insanity only comes with time (typically 1d6 months). It is not dependent upon the character's total Sanity points and is not connected with them. A character can be sane with 24 Sanity points and insane while possessing 77 Sanity points.

Psychiatric Medications

As long as a character can afford a psychiatric medication and is able to take it, the symptoms of indefinite insanity can be ignored. Taking such drugs does not make a character immune or even particularly resistant to further Sanity losses. A Knowledge (earth and life sciences) check against DC 15 is needed to accurately prescribe the correct medications and dosage.

A 50% chance exists that a given drug will have either a physical or mental side effect. If the side effects are physical, the character suffers a -1 penalty to all attack rolls, Fortitude and Reflex saves, and Strength-, Constitution-, and Dexterity-based skill checks. If the side effects are mental, the patient suffers a -1 penalty to Will saves and to Intelligence-, Wisdom-, and Charisma-based skill checks. If more than one medication is taken due to multiple symptoms, the character will automatically have side effects and has a 50% chance for both mental and physical side effects. Side effects last for as long as the medication is taken. The die roll is made one time, upon the first instance of a particular character's taking a particular drug.

Long-term drug therapy can restore lost Sanity, just as use of the Psychoanalysis skill can. For each month the character takes an accurately perscribed psychiatric medication, she regains 1d3 Sanity points. As with Psychoanalysis, long-term drug therapy can never raise a character's current Sanity above starting Sanity.

A character cannot benefit from both Psychoanalysis and drug therapy in the same month.

Level Gains

When a character gains a level, she gains Sanity. This gain comes from the satisfaction of improving yourself and gaining experience.

Since levels are gained as a result of experience points, and experience points are earned by overcoming threats and challenges, a character who gains levels realizes that while fantastic horrors assail our world, they can be bested – or at least driven off for a time.

Each time a character rises to a new level, roll 1d6 and add the result to the character's current Sanity. Points gained from advancing in level are not subject to the restriction of starting Sanity. They can raise current Sanity to any total equal to or less than maximum Sanity.

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