Short-Term Madness Table

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Short-Term Madness Table

Random Table

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 Glyph of Mortality, can cause insanity, and you can use the madness rules here instead of the Spell effects in the PG. 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 Mind Contesting Roll.

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 minutes.

A character afflicted with long-term madness is subjected to an effect from the Long-Term Madness table for × 10 hours.

A character afflicted with indefinite madness gains a new character flaw from the Indefinite Madness table that lasts until cured.

Short-Term Madness Table

	Effect
1	The character falls Unconscious. The character retreats into his or her mind and becomes Paralyzed. The Effect ends if the character takes any damage.
2	The character will have an obsession with flipping a gold coin for every decision they make. Tossing Heads is a success (meaning they may proceed with their decision.) Tails is a failure.
3	The character will have the uncontrollable urge to defecate and will use their turn to move to the nearest location out of sight, drop their pants, and try to poop. Each round the player rolls a d4, a d6, and a d8. If the player rolls a 2 on any of the dice, they successfully defecate whether their pants are on or off. On any other roll, the player uses their action to try again.
4	The character becomes paralayzed for 1d4 rounds and spends each round affected in the following order: laughing, weeping, screaming, then curled up in the fetal position mumbling.
5	The character becomes Frightened of the nearest creature and must use his or her action and Movement each round to flee from the source of the fear. This ends if the source is eliminated or the character loses line of sight.
6	The character believes they have extra, imaginary appendages, and they try to use whatever extra limb they believe they have, which obviously never works. They may use an extra action. If they do, the GM rolls a die to determine which action is real and which is imaginary.
7	The character begins babbling and is incapable of normal Speech and is silenced.
8	The character begins foaming at the mouth and must use their turn each round to Attack the nearest creature to their fullest ability.
9	The character thinks they are a vampire and spends 1d4 rounds attempting to bite the nearest creature. They use a natural bite weapon if it exists, otherwise they drop their weapons and use the slam or fist weapon.
10	The character experiences vivid hallucinations and has DIS on skill rolls. During combat, the player must succeed on a DC12 Psyche. On a fail, the character attacks the hallucination instead of its intended target.
11	The character hears a loud heartbeat in their ears and is unable to hear anything else. They have disadvantage against attacks from behind. They are considered deafened.
12	The character feels like their clothes are on fire and believes the nearest character is to blame for their pain. The character uses their turn to doff their clothing and armor, believing this is the source of their pain.
13	The character thinks they suddenly changed gender.
14	The character experiences an overpowering urge to eat something strange such as dirt or slime.
15	The character becomes overly critical against the party members, and mocks and insults them even for the slightest mistake.
16	The character experiences uncontrollable tremors or tics, which impose DIS on Fortitude and Attack Rolls.
17	The character begins to feel a tingling sensation in their skin. For 1d4 rounds, they feel the need to press their body against the nearest creature or grabbable object. If it’s a creature, they try to grapple it.
18	The character breaks out into song for the duration of the fight. If the player does not sing a stanza or chorus during their turn, the character falls unconscious.
19	The character becomes suffused with adrenaline for 1d4 rounds. During that time they gain ADV on all attack rolls. After the effect wears off, the character is stunned for 1 round.
20	The character must now breathe manually, giving disadvantage to concentration checks and any skill checks related to speaking.
21	Your character is convinced they are a Lycanthrope and will seek out a cure. On a full moon, they will shed their clothes and try to bite people. If your character IS a Lycanthrope, they believe they aren't.
22	The character starts walking sideways to the left. He doesn't notice he's doing it, and will not believe it when other characters make him notice.
23	The character has a sudden and irresistible craving for raisins and other dried fruits. Until they spend a turn eating dried fruit.
24	The character becomes extremely hydrophobic as all water in the area appears (from their perspective) to become black with the thick scent of decay.
25	The character is induced to slice and drink the blood of the nearest enemy (using a 1ap to lick it off their weapon).
26	The character sees deeper into the shadows than they could before, but not by distance. They can look into the depths of the darkness and see the small bird-like spirits that have been watching the party this whole time. Making eye contact with them (inevitable if looking into the darkness) causes them to spend a round launching themselves at the player in a flock only they can see, forcing them to spend 2ap fending them off.
27	The character begins to hear a faint singing from children, the words indistinguishable and the tune being similar to a nursery rhyme they can't quite place. They can catch glimpses of children hiding in the foliage, peeking out from between barrels or windows, or lurking amongst a crowd. The song drowns out whispers or faint sounds.
28	The character suddenly twists its perspective and is now extremely sure that everyone (besides itself) sees the world upside down. It will then proceed to walk on their hands, hold their weapons and wands in the wrong direction, and completely misunderstand simple concepts involving gravity (e.g., if you'll jump you'll fall, you should aim your arrow higher than your target because the arrow's height decreases with distance, things break when dropped from height, etc.). All attacks are made at DIS.
29	The character becomes certain that it is completely and utterly blind. It will not gain the blinded condition but will avoid doing activities usually requiring sight (long-ranged weapons, reading a scroll, evading a hit, etc.). However, it doesn't dislike its fake blindness and will try to gouge out other creatures' eyes, not out of malice, but to help the poor souls that have not been blessed by the perfect darkness that embraces it. When no creature within 100 ft. of the character has their sight, the character will gouge out their own eyes.
30	The character feels bugs crawling under its skin. Every turn they don't take damage, they take 1d8 slashing damage as they attempt to dig the insects out of their flesh. Upon losing half their current health from the moment they were driven mad or after 1 minute (whichever happens first), this effect stops.
31	The afflicted begin speaking in tongues, whispering in languages that have been dead for centuries. They become immobile speaking gibberish, and fail any casting of a spell requiring verbal componentts.
32	The character suddenly feels the pain they witness. Any damage dealt to any creature within 15 ft. is halved and taken by the character as non-lethal psychic damage. The character can choose to close their eyes as a reaction, avoiding damage but becoming blinded until their next turn. If they are reduced to zero vitality, they fall unconcious from this effect.
33	Madness drives the user to frantically draw a ritual circle on the floor by any means necessary, using ink, digging out mud, or -if there are no other options- taking 1d4 of piercing damage and using their own blood. They miss one round, and at the end of their next turn, the circle will cause a random spell with the ritual tag to be cast immediately, centered on the ritual circle. If it requires a target, use the nearest creature.
34	The character feels like it is possessed by a spirit of nature and starts acting as one of four spirits (roll a d4). The swimming spirit: Examples: jellyfish, salmon, whale. Consequences: lack of fear of drowning, a feeling of unease and drowning when outside of water.
35	The character feels like it is possessed by a spirit of nature and starts acting as one of four spirits (roll a d4). The jumping spirit: Examples: bunny, rabbit, tick. Consequences: acquiring a bizarre form of four-legged walking, involving rapid and unsuccessful jumps.
36	The character feels like it is possessed by a spirit of nature and starts acting as one of four spirits (roll a d4). The unmoving spirit: Examples: seaweed, tree, anemone. Consequences: a deep resentment towards moving out of your location.
37	The character feels like it is possessed by a spirit of nature and starts acting as one of four spirits (roll a d4). The flying spirit: Examples: mosquito, bird, dragon. Consequences: lack of fear of heights, and a general disliking to hold objects with its hands.
38	The character becomes absolutely convinced that a random enemy is actually their ally and has been the whole time. They become as devoted to this enemy as they are to their regular allies. When the enemy is slain, this effect ends.
39	The character is compelled to stay within 5 ft. of a random ally, suffering disadvantage on all rolls when not within 5 ft. of them. The character becomes absolutely convinced that they will die if not next to this ally.
40	The character begins uncontrollably weeping, but can otherwise act as normal. They suffer disadvantage on all perception checks that require sight.
41	The character decides this combat is dumb, actually. All attacks are rolled at disadvantage, as they're just not feeling it. This effect ends if the character's V goes below half
42	The afflicted thinks every other creature is more powerful than it, and treats them with either respect or fear.
43	The afflicted thinks its power became overwhelming, and hardly ever attacks out of fear of breaking the world.
44	You realize you are in a game, and everything that makes you the person you are is just a collection of numbers and a few sentences on a sheet of paper.
45	The insane person suffers from extreme paranoia and treats ALL creatures as 'hostile.'
46	The afflicted has memory issues. Whenever he needs to remember something, roll a d4. If the result is a 1, the person forgets everything about it.
47	The afflicted is bipolar. Every 1d20 hours, roll 1d10. If the result is even, the person acts overly friendly. If it's odd, the person tends to be aggressive.
48	The effected believes everything to be a conspiracy- this town is run by doppelgangers, the king is a dragon in disguise, the Gods aren't real, etc.
49	The effected develops a pathological hate of ducks.
50	The effected suffers from autocannabalism, and finds the taste of their own flesh more delicious than anything else.
51	The effected hears the constant sound of rolling dice.
52	The effected hears the voice of their grandmother (or similar familial character) occasionally telling them to kill people.
53	The effected doesn't feel safe alone, and will panic unless accompanied by another character.
54	The effected develops triskaidekaphobia, an irrational fear of the number 13.
55	The effected develops a drinking problem.
56	The effected suddenly overcomes an addiction or other character flaw, then suffers a violent outburst 1d4 days later.
57	The affected develops trypophobia.
58	The character develops narcolepsy. Every 1d20 hours, roll a 1d8. If the result is 3 or lower, the character falls asleep for 1 hour, and sleepwalks 1d4 x 20 feet in a random direction at any moment during that hour.
59	After taking damage the afflicted behaves as though under the confusion spell the following round.
60	The affected person seems to think they have switched bodies with the first person they see every day.
61	The victim, in their madness, cannot comprehend words unless spoken completely backwards.
62	The affected has an unnatural obsession with black hair.
63	The affected person sincerely believes they can cast the spell Wish Fullfillment at will, and tries to cast it frequently.
64	The afflicted grows to believe their skin is incredibly durable, and refuses to wear armor of any kind.
65	The affected, when addressed by name, will paralyze themselves in fear until left completely alone.
66	The maddened individual will feel compelled to spout nonsense in the middle of their sentences.
67	The character now only talks in third person.
68	The PC can see and hear other NPC(s) interacting with them sometimes, only they are actually hallucinations. The PC is unaware that they are hallucinations to start out, but may learn that later.
69	The afflicted finds everything to be absolutely delicious.
70	You start with nightmares of charnel hounds catching you and tearing at your flesh. Upon waking you can still hear them growling and breathing behind you. The symptoms become so severe that you hallucinate being attacked by the hounds and can feel pain (1d6 psychic damage) when they bite.
71	Your character develops the paranoid delusion that a random party member is always watching them.
72	Your character is convinced they are the Chosen One of the first prophecy they hear, and will seek to fulfill their destiny no matter how impossible.
73	Your character will occasionally 'speak to camera', do voiceover narration for events currently occurring, and sometimes speak their thoughts aloud, exactly as though they are a character on a TV show... they believe the Gods are watching their adventures for entertainment.
74	The afflicted is incredibly terrified of the dark because of the unspeakable creatures and horrific sounds that exist there, so they always carry some form of light and are likely to freak if it ever goes out.
75	The afflicted is completely convinced that they have been made god over something incredibly small, specific, and pointless, and they make sure everyone knows about their newfound divinity.
76	The afflicted knows, without a doubt, that they are the real, biological parent of someone else (ideally, a PC); and they want to make it up to their child for never having realized this before.
77	The afflicted has made a startling realization: everyday is a different holiday! And they mean to celebrate the holiday with the most passion and fervor ever seen. (modified: changed condition)
78	The afflicted sees everything as being in a slightly different physical place than it actually is. It’s a tiny, almost insignificant different, but It is very noticeable when in direct conversation with them because they never make actual eye contact. They look the smallest bit away.
79	The afflicted has seen the errors of popular belief and have decided to be as counter to the norm as possible. They might refer to everything in opposite terms (like saying “down” for “up), wear clothes backwards or upside-down, or in extreme cases, even do the exact opposite of what they think others desire of them.
80	The afflicted does not think they exist anymore and does not believe people can notice, perceive, or interact with them. When spoken to or observed, they don’t believe it—others must be interacting with something nearby. It’s just a coincidence! Physical touch of any type is ignored, and if physically moved or hurt, the afflicted believes they must be hallucinating or having a vivid dream.
81	The afflicted believes that they know someone of great importance (ideally, someone the PCs are needing to meet/encounter/etc.), but they cannot ever lead anyone to this person. They are happy to speak about them, provide insights about this person, and even regale others of stories that involved the two together. However, they can never disclose the physical location of the person or lead others to the person because if they do, they believe they will break their end of some bargain and something terrible will occur.
82	Your character begins to feel that their self worth is elevated, almost in a euphoric state as their false confidence causes them to be too confident in their abilities.
83	The afflicted believes that their hands and feet have been replaced with spoons.
84	The afflicted person believes he suffers from spontaneous combustion, and whenever there's a talking bit, he has to roll whether he is fine, or spends the entire chat rolling on the floor and screaming.
85	The inflicted player is convinced their lives and everything in their world is controlled by giant gods that surround them at all times. The PC will occasionally hear giant boulder size rocks roll somewhere, before something happens.
86	You will have an obsession with flipping a gold coin for every decision you make.
87	You start spinning and humming 'Twinkle-twinkle' for hours on end.
88	You find a pineapple (or any available fruit) named 'Wilson' that speaks for you now.
89	You believe every full moon you turn into a were-rabbit that craves cheese.
90	When you sleep, you dream of a lake of fire. It's the same dream every night. You know it exists somewhere in the world. When you wake, you can feel it pulling you, calling to you. You do everything in your power to travel to this lake. GM decides how far away it is. You know it's the right lake when you get there. Once you arrive, you find it to be very much so not on fire. Take 3d10 psychic damage as you struggle to reconcile this, and the madness ends.
91	You now believe you are the physical incarnate of the deity you have devoted your life to. Alternatively for classes not devoted to a deity, you now believe you are a deity worthy of devotion, gain the ability to cast prestidigitation (poorly) to prove your divinity to those foolish enough to question your power!
92	The person feels like someone is watching them constantly and cause him/her to shoot out random things in any random direction
93	The afflicted thinks that party members are close relatives (father, mother, brother etc.)
94	The afflicted becomes overly critical against the party members, and mocks and insults them even for the slightest mistake.
95	The afflicted starts thinking selfness is the only way to get home alive, and will always choose what is better for him and not for the whole party. He will always refuse to share things.
96	The afflicted start going irrational, talking about his past and commenting everything in weird ways, using terms like madness, darkness, void, etc.
97	Character develops 'Object is God' disorder: first stage, they hear voices. As they tear about, one voice comes through more strongly than the rest, from a certain direction. Whatever the direction, they wander, until a doll or stuff item is found. The voice they've been hearing, 'attaches' itself to the item, and 'speaks' through it. The item then MUST be obtained. Finally, any choice the inflicted makes must be made through the toy.
98	Character becomes extremely sadistic. Deaths elicit the most laughter - the gorier, the more happiness is achieved.
99	A fear of growing older is instilled in them--and a desperation to never grow feeble. Impatience is formed as a result of the knowledge that with every passing second they are slowly dying, and as such they have a short fuse.
100	They must save everyone! When asked 'from what', the response is 'from evil!' before trying to murder everyone.
101	Afflicted develops an uncontrollable fear of water, including ice and bottled water. He may even let himself die of thirst.
102	Character starts worshipping a deity referred to simply as 'The Game Master', who supposedly controls everything about the world, except for the party.
103	Character develops a compulsion for feeding any creature it sees, with whatever is at hand.
104	The affected is convinced that he/she is a vampire, and will seek out humanoid blood. Also takes 1d4 psychic damage per minute of sun exposure, and believes the image of him/herself in mirrors is an illusion.
105	The person decides to create a massive loot hoard, not unlike ones in a red dragon den. Person will take any gold and valuables they see, by whatever means they see fit, and then take them to their home.
106	The afflicted character verbalizes all of their internal thought processes unless they put a concerted effort into not doing so. While suppressing the verbalization of their thoughts, they have disadvantage on skill checks and saves, cannot cast Concentration spells, and speak in strained and broken sentences.
107	The afflicted believes their body parts have separate personalities and spends most of their time trying to broker peace between them.
108	The affected pc adopts the personality of another character, and fully believes that they are that character. Lasts until cured, or the effect wears off.
109	The affected believes that they can talk to their weapon. If the affected does not have a weapon, then they believe themselves to be able to communicate with another party members weapon.
110	The afflicted is plagued by night terrors that comprise of all the ways the afflicted might die that next day. Paranoid to the point of hysteria, they do everything with incredible fear and caution, often mumbling about the many ways whatever they're doing might kill them.
111	The afflicted finds the most inconvenient things to be absolutely hilarious, bursting into cacophonic laughter at the worst times.
112	The afflicted never lets one of their senses function properly because they falsely believe that they are better without that sense. Their self-imposed handicap has become their good luck charm and security blanket, although it actually makes them worse, so they fight tooth-and-nail to never use whatever sense they have shunned.
113	The afflicted is convinced they hold multiple personalities in their psyche, except all the personalities act exactly the same in every respect and the only difference is that each personalities' name differs by one letter.
114	The afflicted has developed a pitiful version of photographic/eidetic memory where they only clearly remember things when in near-death situations, so they actively seek lethal or painful experiences in order to use their incredible recollection abilities.
115	The afflicted fears that lying in any way spells their end and have become genuine and honest to a fault. They say whatever is on their mind, though with obvious terror, shame, or hesitation.
116	The afflicted believes they have extra, imaginary appendages, and they try to use whatever extra limb they believe they have, which obviously never works.
117	The afflicted has realized that fate rules everything and nothing is not predestined. They are incredibly melancholic and fatalistic, and they must be driven and prodded into action to do anything other than sigh and accept their fate.
118	The afflicted obsessively takes up the ambition of being a writer, and they neurotically write everything down for some ambiguous chronicle that they are always working on.
119	The afflicted is convinced that everyone else is flirting with them somehow, and they are appalled at how libido-driven everyone seems to be. Ironically, they become terrible at hitting on people.
120	The afflicted's sense of time is confused. They speak of the past as if it's in the future and has yet to happen. They speak of the future in past tense. And they have very little grasp of the present moment.
121	The afflicted becomes a mild pyromaniac. They have to make a DC8 Psyche every time they see a fire. On a fail, they try to spread that fire once they are safe to do so.
122	The character partially loses the sense of hunger. Every 1d20 hours, they have to make a DC8 Psyche. On a fail, they believe to be extremely hungry, and will do anything they can to get a meal.
123	The affected becomes addicted to the first smell that reaches their nose. If they are not able to smell it every 12 hours, they become violent.
124	The afflicted believes to be in a dream, and is constantly trying to wake up. However, they are too afraid to try to commit suicide in order to wake.
125	The afflicted has a dream, in which they see their own death, in a rather specific way. The GM decides what the dream is like, so it is exactly like a situation the party will go through. The afflicted then recognizes the scene, and panics.
126	The character is suddenly attracted to their own image, even though they don't recognize it. They try to talk to themselves in the mirror, fully believing it's a different person, and the love of their life.
127	The person grows extremely afraid of gravity. Even a tiny unevenness makes them pee their pants.
128	The afflicted grows an interest for poetry, and starts making their own, terrible poems.
129	The afflicted is convinced they know a lot about subjects they only know a little of, and makes a lot of assumptions to fill their knowledge's holes.
130	The character believes they have an angel on one shoulder, and a demon on the other. Both of which represent a side of their consciousness, and gives their respective advices. The character doesn't know which is which.
131	The person believes they are getting older way faster than others, and that their physical capacities are decreasing as well.
132	The afflicted thinks it's rude to drink or eat in public, and will hide from anyone else before they do one of these things.
133	The afflicted suddenly 'remembers' they are a double agent, meant to strike down whoever the party is working for, and their party members are part of the scheme, just don't remember it.
134	The person is convinced that the end is near, and there's nothing they can do to stop it. So, they decide to live the rest of their days as hedonistically as possible.
135	The person believes to be aging backwards, and getting progressively younger, They mistake signs of senescence for signs of youth.
136	The person believes they are a polymorphed metallic dragon, stuck in human form. They set out to fix their 'curse'.