Chapter 14 · Running the Game
Madness
In a typical campaign, characters aren’t driven to madness by the horrors they face and the carnage they inflict day after day, but sometimes the stress of being an adventurer can be too great a burden to bear. If your campaign has a heavy horror theme, you may want to use madness as a way to reinforce that theme, emphasizing the extraordinarily terrible nature of the threats adventurers face.
Going Mad
Various magical effects can inflict madness on a mind that would otherwise be stable. Certain spells, such as contact other plane and symbol, can cause insanity, and you can use the madness rules here instead of those spells’ magical effects. Diseases, poisons, and effects from other realms can all inflict madness. Some artifacts can also break the psyche of a character who uses or attunes 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, something that lasts only a few minutes. More terrible or cumulative effects can result in long-term or indefinite madness.
A character afflicted with short-term madness is subjected to one of the effects on the Short-Term Madness table for 1d10 minutes.
A character afflicted with long-term madness is subjected to one of the effects on the Long-Term Madness table for 1d10×10 hours.
A character afflicted with indefinite madness gains a new trait described on the Indefinite Madness table that lasts until they are cured.
| d100 | Effect (lasts 1d10 minutes) |
|---|---|
| 01-20 | The character retreats into their own mind and becomes Paralyzed. The effect ends if the character takes any damage. |
| 21-30 | The character becomes Incapacitated and spends the time screaming, laughing, or crying. |
| 31-40 | The character becomes Frightened and, at the start of each turn, must use their action and movement to flee from the source of the fear. |
| 41-50 | The character begins babbling and is unable to speak normally or cast spells or sutras. |
| 51-60 | The character must use their 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 asks them to do, as long as it isn't obviously self-destructive. |
| 76-80 | The character experiences an irresistible urge to eat something strange, such as dirt, sludge, or waste. |
| 81-90 | The character becomes Stunned. |
| 91-00 | The character falls Unconscious. |
| d100 | Effect (lasts 1d10 x 10 hours) |
|---|---|
| 01-10 | The character feels compelled to repeat a specific activity over and over, such as washing their 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 from extreme paranoia. The character has disadvantage on Wisdom and Charisma checks. |
| 31-40 | The character regards something (usually the source of the madness) with intense revulsion, as though affected by the antipathy/sympathy spell. |
| 41-45 | The character experiences a powerful delusion. Choose a potion. The character believes they are under the effects of that potion. |
| 46-55 | The character becomes dependent on 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 their charm. |
| 56-75 | The character is Blinded (25%) or Deafened (75%). |
| 76-85 | The character experiences uncontrollable trembling or nervous tics, imposing disadvantage on attack rolls, ability checks, and saving throws that involve Strength or Dexterity. |
| 86-90 | The character suffers from partial amnesia. The character knows who they are and retains their origin traits and class features, but doesn't recognize other people or remember anything that happened before the madness took effect. |
| 91-95 | The character loses the ability to speak. |
| 96-100 | The character falls Unconscious. No amount of shaking or damage can wake the character. |
| d100 | Trait (lasts until cured) |
|---|---|
| 01-15 | "Getting drunk keeps me sane." |
| 16-25 | "I keep everything I find." |
| 26-30 | "I try to become more like someone I know — adopting their style of dress, mannerisms, and name." |
| 31-35 | "I must twist the truth, exaggerate, or outright lie to be interesting to other people." |
| 36-45 | "Achieving my goal is the only thing that interests me, and I will ignore everything else in pursuit of it." |
| 46-50 | "I find it hard to care about anything going on around me." |
| 51-55 | "I don't like how people judge me all the time." |
| 56-70 | "I am the smartest, wisest, strongest, fastest, and most beautiful person I know." |
| 71-80 | "I am convinced that powerful enemies are hunting me, and their agents are everywhere I go. I'm sure they're watching me at all times." |
| 81-85 | "There is only one person I can trust. And only I can see this special friend." |
| 86-95 | "I don't take anything seriously. The more dire the situation, the funnier I find it." |
| 96-00 | "I've discovered that I really enjoy killing people." |
Curing Madness
The calm emotions spell can suppress the effects of madness, while a lesser restoration spell can free a character from short-term or long-term madness. Depending on the source of the madness, remove curse or dispel good and evil may also be effective. A greater restoration spell or something more powerful is needed to free a character from indefinite madness.