Madness

Madness can be short-term, long-term, or indefinite.
More mundane effects, like the ones presented here,
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 creature’s intellect can help it understand eldritch
knowledge without breaking its mind. Characters can
add their Intelligence modifier to saving throws they
make against madness.
● When a creature becomes afflicted by madness, be it
short-term, long-term or indefinite, the creature is
stunned (see the condition) until the start of its next
turn, and then the madness takes effect.
● A character afflicted with short-term
madness is subjected to an effect from the
Short-Term Madness table for 1d4
minutes.

● A character afflicted with long-term madness is
subjected to an effect from the Long-Term Madness
table for 1d4 × moons (or 1d4 x 7 days, if you aren’t
using eldritch moons in your world).
● A character afflicted with indefinite madness gains a
new trait from the Indefinite Madness table that lasts
until cured.

GM Note:
If you don’t know when to apply longterm
or indefinite madness, here is a rule
of thumb to follow. Each time a character
accumulates three forms of short-term
madness in less than 48 hours, they gain
a form of long-term madness. If a
character gains three forms of long-term
madness in less than 30 days, they gain a
form of indefinite madness. Feel free to
alter these numbers if you want to see
more or less madness in your game.

SHORT-TERMMADNESS
D100 D10 Short-TermMadness
1-10
Your mind is liberated
from any sense of self
you may possess
1-2 Without an ego, you are immune to the charmed condition.
3-7 You mimic the mannerisms, behaviour, and speech patterns of the creature closest to you
when you gained this madness.
8-10 Desperate to find yourself again and believing anything, you automatically fail saving
throws against being charmed.
11-20
Your mind is invaded by
the sound of the cosmos
1-2 Painful sounds pale in comparison to the cacophony in your head; you are immune to
thunder damage.
3-7 Eldritch utterings scratch your brain; you hear the soft caress of whispers behind your back.
8-10 The sound of the cosmos drowns out all other noise, closing you to the world. You are
deafened and have disadvantage on saving throws made to maintain your concentration.
21-30
You have seen too much;
your mind can’t
understand it, causing
your sight to become
erratic and unreliable
1-2 Your vision expands as if you are under the effect of the see invisibility spell.
3-7 Spectral forms flitter at the corners of your eyes, vanishing when you turn your head.
8-10 You are blinded, and you can't use any special senses you use to see, such as blindsight
or tremorsense.
31-40
The madness inside you
bursts forth as haunting
screams
1-2
Your scream is so loud that it can cause damage. As a bonus action on each of your turns,
you can scream at a creature you see within 30 feet of you. If the target can hear you, it
must make a DC 13 Constitution saving throw, taking 1d12 thunder damage on a failure
or half as much damage on a success.
3-7 You can’t talk properly; yelling is the only way you can communicate.
8-10 Your screams are so overwhelming that any creature within 300 feet of you can hear you
talk. You also can’t form coherent sentences or utter the vocal components of spells.
41-50
Your posture crumples,
as you try to make sense
of the insanity before
you
1-2
You become incredibly skittish. When you are the target of an attack or an effect that
requires you to make a Dexterity saving throw, you can use your reaction to begin
moving evasively, gaining a +1 bonus to your AC and advantage on Dexterity saving
throws until the start of your next turn.
3-7 You desperately look for a parental figure that can protect you. Once you find such a
person, you latch on to them and refuse to leave their side, no matter what.
8-10 You fall prone and can’t stand, as your legs refuse to obey you, and you can’t use any
flying speed you possess.
51-60
You realize that your
hands are blasphemous
tools
1-2 These tools can break the minds of your foes. Once per turn when you hit a creature
with a melee weapon attack, you can deal an additional 1d8 psychic damage to it.
3-7 You refuse to use your hands for anything, keeping them hidden from view. If someone
stares at them, it makes you extremely uncomfortable and defensive.
8-10 You shouldn’t touch anything. You drop anything you are holding , and can’t hold items
or grapple creatures.
61-70
Your body breaks down
under the insanity.
1-2 You are immune to the poisoned condition.
3-7 You start emitting a foul smell that is unpleasant even to you, and no amount of washing
or magic can remove it.
8-10 You are poisoned, even if you are immune to the condition.
71-80
The Eldritch Horrors
are revealed to you,
bathing you in fear.
1-2
Each creature within 30 feet of you must succeed on a DC 13 Wisdom saving throw or
become frightened of you for 1 minute. A frightened creature can repeat the saving throw
at the end of each of its turns, ending the effect on itself on a success.
3-7 You become paranoid and fearful of any movement or sound.
8-10
You become frightened of your allies. You must take the Dash action and move away from
them by the quickest available route on each of your turns, unless there is nowhere to
move. If you start your turn in a location where you can’t see any of your allies, you can
use your action to end the madness.
81-90
The madness breaks
your mind.
1-2
You realize your mind has been holding back your body, and you can now act freely. You
have an additional action on each of your turns. That action can be used only to take the
Dash, Disengage, Hide, or Use an Object action.
3-7 You burst into spontaneous fits of laughter randomly, even at the most inappropriate times.
8-10 You are incapacitated. This effect ends early if you take damage equal to at least twice
your level or if a greater restoration spell is cast on you.
91-95
The revelations from
beyond afflict you.
1-2 Your body ignores all pain, only the Eldritch Truth matters; you are immune to the
stunned condition.
3-7 You speak to others of the Eldritch Truth in a way that seems limpid to you, but is
perhaps not so clear to others. Your sentences are cryptic for the unascended mind.
8-10 You are stunned. This effect ends early if you take damage equal to your level or if a
greater restoration spell is cast on you.
96-100
The beast within you
awakens and attempts to
take control.
1-2
Your body releases its animalistic instincts, without the influence of your mind to
restrain it. You are under the effect of the haste spell, although it doesn’t require
concentration. The spell ends when the madness does.
3-7 Your speech is slurred, as if you’re intoxicated, and you punctuate your sentences with
animal noises.
8-10
You fall unconscious, your mind fighting it's hardest to not let you become a beast. This
effect ends early if you take damage equal to your level or if a greater restoration spell is
cast on you.

Long-TERMMADNESS
D100 D10 Long-TermMadness
1-10
The eldritch corruption
profoundly weakens your
body.
1-2 Your frail body is easily pushed around; each time you take damage you are pushed back 10
feet.
3-7 You are easily fatigued, and physical effort puts a heavy toll on your body. You require 4
more hours than usual to complete a long rest.
8-10 Your legs can barely hold you up; each time you take damage you are knocked prone.
11-20
Otherworldly magic
stirs within you
1-2 Your contact with the beyond awakens powers within you. You gain one random cantrip
from the warlock spell list. Charisma is your spellcasting ability for this spell.
3-7 You become repulsed by this world’s magic. Each time you cast or are affected by a spell, you
retch and reel, losing your reaction until the start of your next turn.
8-10
You cannot handle the newfound magic within you, which sporadically seeps from you
when injured. Whenever you take 15 or more points of damage from a single attack, you
explode in a discharge of arcane energy. Each creature in a 10-foot radius centered on you
(including you) must succeed on a Constitution saving throw or take 2d10 force damage.
This explosion cannot be triggered again for 1d6 rounds.
21-30
Your sense of worth
shatters
1-2 Intense paranoia forces you to be on the alert for anything and anyone, protecting what
little is left of you. You gain a 1d4 bonus to any Perception or Insight check that you make.
3-7 You are sulking and sullen; these negative thoughts in your head cause you to demean
yourself during any conversation you have.
8-10
Your worthlessness seeps into every aspect of your life, gnawing at whatever remnant
of competence you have left. Any time you make an ability check, roll 1d4 and subtract
the number rolled from the result.
31-40
You lose perception of
your power.
1-2 Not realizing your limits, you push yourself beyond what you are capable of. Whenever
you deal damage, add damage equal to one roll of the lowest damage die used.
3-7
You don’t realize your strength; whenever you have to use your body, you either put way
too much force or not enough. Your handshakes can be like a vice grip or dead fish, your
hugs suffer the same fate, and any other physical activity you try to perform is a gamble.
8-10 Afraid of shattering your body, you involuntarily restrain your power. Whenever you
deal damage, subtract damage equal to one roll of the lowest damage die used.
41-50
The Eldritch Truth
reveals itself to you
1-2
Able to understand this Truth, you gain proficiency in a random Intelligence skill
(chosen by the GM) and can add twice your proficiency bonus to any check you make
using that skill.
3-7
You become fascinated by what lies beyond. Whenever you notice or hear of something
of eldritch nature, you drop whatever you are doing to enquire more about it, and
attempt to get closer to it, physically or otherwise.
8-10 The revelations from beyond beckon to you, urging you to learn more, to be more. You
have disadvantage on saving throws against madness.
51-60
The madness ignites
your nervous system,
melting it away
1-2 Any pain you would feel completely vanishes. You are immune to being stunned and can
only fall unconscious as a result of reaching 0 hit points.
3-7 Your damaged nerves transmit a constant feeling of itchiness. This feeling vanishes
when your skin is in direct contact with metal.
8-10
You are in constant pain from the nerve damage, which prevents you from focusing or
bringing your utmost in battle. You can’t add your Dexterity modifier to your Armor
Class and have disadvantage on all Dexterity checks and saving throws.
61-70
Powers from beyond
grasp you and merge
with your body
1-2
You manage to bring these otherworldly powers under your control. You have advantage
on Constitution saving throws to maintain concentration. In addition, if you fail a saving
throw, you can choose to succeed instead. If you do, you then need to roll on the long-term
madness table again, gaining a new effect.
3-7
Attempting to understand what has merged with you, you start experiencing
derealization. You are completely alienated from your surroundings at all times, and get
surprised by any physical contact.
8-10
These new powers are too much for you to handle, draining your mind. You have
disadvantage on Intelligence checks, Wisdom checks, and Charisma checks, as well as
Constitution saving throws to maintain concentration.
71-80
Your heart begins to
falter, such a reality
cannot possibly exist
1-2 Your elevated heart rate increases your awareness. You gain a +3 bonus to your passive
Wisdom (Perception) score and your initiative.
3-7
The unexpected is too much for you to handle. Whenever you are surprised you scream
at the top of your lungs. If you are surprised in combat, you fall unconscious until the
start of your next turn.
8-10
Your heart weakens, literally. You gain a level of exhaustion which cannot be removed until
the madness ends. Whenever you become frightened, you gain another level of exhaustion.
Apart from the first, exhaustion gained from this madness can be removed as normal.
81-90
Your futile attempts at
staving off the madness
have left your body
scarred
1-2 The scar tissue only thickens your skin. You gain a +1 bonus to AC.
3-7
The scars that cover your body are beyond repulsive, causing most people to experience fear
at their sight, especially children. You have a +2 bonus to Intimidation checks and a -2
penalty to Persuasion checks.
8-10
You suffer severe scarring over an extensive portion of your anatomy. Anytime you
suffer bludgeoning, piercing or slashing damage, you suffer an additional 1d6 damage of
that type.
91-95
The madness causes
your body to rot, unable
to withstand the eldritch
influence
1-2 Your mind embraces the idea that your body will rot away, and welcomes it; after all,
everyone withers away eventually. You have immunity to the poisoned condition.
3-7 The rot within your body is nauseating. You experience a constant feeling of disgust,
and any time you smell something foul, you spend your Action heaving.
8-10
Vicious wounds of eldritch nature ravage your flesh. Your hit point maximum is reduced
by 1 every 24 hours. If your hit point maximum drops to 0, you die. You or another
creature can tend to the wounds during a long rest, making a DC 16 Wisdom (Medicine)
check once every 24 hours. After five successes, the wounds heals.
96-100
The beast within you
awakens and takes
control
1-2
Most of your humanity remains, yet enough of the beast is unleashed. You gain
advantage on Dexterity saving throws. In addition, each of your hands transforms into a
claw, which you can use as a weapon if it’s empty. It deals 1d6 slashing damage on a hit.
Once on each of your turns when you attack with a claw using the Attack action, you can
make one additional claw attack as part of the same action.
3-7
Your body transforms, yet a trace of your humanity remains. Your race becomes
scourgeborne, with a random subrace. Scourgebornes and constructed races, such as
manikins, are immune to this effect.
8-10
Your body transforms into a beast or monstrosity of the GM’s choice with CR equal to
half your level (rounded up). Apart from this, your transformation follows the rules of
the polymorph spell, though if you fall to 0 hit points, you fall unconscious instead of
reverting to your normal form.