Madness

D&D 2024 rule: Madness. Source: Dungeon Master's Guide (2014). rule type Rule 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 in the Player's Handbook. 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. If your game includes the New Ability Scores: Honor and Sanity (see chapter 9, "Dungeon Master's Workshop"), a creature makes a Sanity saving throw instead. 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 Madness table that lasts until cured. 01-20 The character retreats into his or her mind and becomes paralyzed. The effect ends if the character takes any damage. 21-30 The character becomes incapacitated and spends the durat...