There is no turning back when it comes to video games, and it’s continually impressive to see how the medium of entertainment evolves and pushes technology to exciting, new places. The entire industry that surrounds video games has made great leaps forward when it comes to technology, immersion, and radical gameplay mechanics.

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However, some specific gaming genres have transformed more than others, with the survival horror niche going through significant growth. Horror titles often prioritize scares, but the advent of a sanity or fear meter attempts to add a psychological factor to the experience. This idea has been explored to various degrees of effectiveness, but it always results in some unpredictable gameplay.

10 Eternal Darkness: Sanity’s Requiem Makes The Player As Vulnerable As The Characters

Video Games Eternal Darkness Shutdown Sanity Effect

It’s impossible to discuss fear and sanity meters that attempt to get in the player’s head without a look into the standout Gamecube release, Eternal Darkness: Sanity’s Requiem. Eternal Darkness’ sanity effects are displayed in aesthetic ways that make the game more confusing, but they also take some ambitious leaps, like making the player think they’ve erased their game’s data, accidentally changed the video input, or volume levels, or that the game has crashed. Eternal Darkness actually patented the concept of a sanity meter, which has pushed other horror games to get more creative with their approaches.

9 The Clock Tower Series Capitalizes On Dying From Fright & Panicked Actions

Video Games Clock Tower 3 Sanity Effect

The Clock Tower series started back on the Super Nintendo and was a successful fringe horror franchise. These games feature a panic meter that has four colors of severity that increases when the character faces frightening traps. If the panic meter isn't properly managed, she becomes more susceptible to traps and dying from fright, and she also trips as she runs. Clock Tower's spiritual successor, Haunting Ground, also returns to this idea through a "Panic Mode," where the player's movement and control become erratic, the screen transforms to grayscale, and the use of items and certain menus become disabled.

8 Amnesia: The Dark Descent Focuses On The Unpredictable Nature Of Insanity

Video Games: Amnesia Dark Descent Monster Sanity Effect

The Amnesia series is one of the most satisfying and terrifying modern survival horror series, and it benefits from a story and imagery that's very rooted in H.P. Lovecraft. Amnesia frequently presents the character's mental stability as a liability. Various declining conditions are experienced unless the player actively solves puzzles to rise above their dark fate.

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If the player doesn't, they'll devolve into a hazy state where the game's screen becomes impaired, insects will invade the interface, and paintings will warp in disturbing ways. At its apex, the player feels like they're being chased by monsters.

7 Illbleed Manages Many Vitals To Amplify The Characters' Vulnerability

Video Games Illbleed Sanity Meters

Illbleed is an overlooked survival horror gem that’s locked away as a Sega Dreamcast exclusive. The game is a glowing love letter to schlocky B-horror cinema that’s set at a deadly amusement park. Illbleed indulges in different horror genres and cleverly leans into their stereotypes. One of the more advanced aspects in the game involves a robust series of vitals, like adrenaline, that need to be managed. Scares and traps can be defused in the game, which replenishes adrenaline and vitality. Otherwise, they become particularly vulnerable, and a basic scare can send them into cardiac arrest.

6 Dead By Daylight’s Doctor Uses His Mad Science To Break Minds

Video Games Dead By Daylight Sanity Effect Screaming

Dead By Daylight capitalizes on the rich world of horror and slasher villains who exist in cinema. Dead By Daylight is a gleeful horror genre mash-up free-for-all. Admittedly, most villains stick to physical violence, but Herman "The Doctor" Carter is able to trigger a type of sanity effect in his victims. The Doctor's electroshock attack makes static appear around the prey's health, but if this grows more intense, then the player begins to experience disturbing hallucinations. Finally, the victim is reduced to bouts of screaming, which gives away their location and temporarily renders them helpless.

5 Elona Examines Mental Clarity To Enhance Its Rich RPG World

Video Games Elona Sanity Effect Dark

Elona, an RPG with a retro aesthetic, isn't a horror game, yet it still incorporates fear and sanity effects in a progressive manner. Elona's sanity meter is actually an insanity meter, wherein a depleted meter with a reading of zero is the player's "healthiest" state.

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The twist in Elona is that it features a civilization that's been driven to insanity and that a level head is actually abnormal. As the player experiences more and more, it will wear down their resilience and possibly result in their end, whether through poisoning, nausea, or even attempts to take one's own life.

4 Cataclysm: Dark Days Ahead Explores The Emotional Toil Of A Zombie Outbreak

Video Games Cataclysm Dark Days Bunker Sanity Effect

Cataclysm: Dark Days Ahead is one of the more creative and challenging games that are centered around a zombie apocalypse. However, rather than just focusing on carnage and survival, Cataclysm also keeps tabs on the player's mental state. Designed as a morality system, the horrors that the player experiences will impair their performance and cause poor combat or an inability to craft or work, and it'll make them slower in gaining stat boosts and learn new skills. Actions like eating healthy food and listening to music can improve the player's morale while eliminating undead children reduces it.

3 Crusader Kings III Properly Examines The Grim Decisions That Fuel The Dark Ages

Video Games Crusader Kings III Sanity Effects

Crusader Kings is a strategy franchise that's set during the combative period of the Middle Ages. This may initially feel like a bizarre context for a fear or sanity meter, but Crusader Kings III incorporates the mechanic in an inspired manner. The Middle Ages were far from a peaceful period of time, so Crusader Kings III utilizes a stress meter that keeps tabs on the player's mental stability. It’s life’s many tragedies, like a corrupt agenda or the loss of loved ones, that increase the stress meter. If this reaches the red, the player faces impaired performance or even death.

2 Fear And Panic In Friday The 13th: The Game Give Jason More Strength

Video Games Friday The 13th The Game Sanity Effects Attack

​​There have been several attempts at Friday the 13th video games, even going back as far as the original Nintendo. The most recent, Friday the 13th: The Game, makes use of a clever fear system when players control camp counselors. Each counselor has a contrasting composure statistic, which corresponds to how much fear they're able to experience. The player's encounters with dead bodies or Jason himself affect their fear, which gives Jason Voorhees and his "sense" skill an advantage. Higher fear results in impaired vision, a disappearing HUD, and the player's character frantically announcing themselves to their predator.

1 The Sims 2 Hints That An Impaired Mental State Is A Part Of Life

Video Games The Sims 2 Sanity Effect Aspiration Failure

The Sims 2 is easily the least intimidating title on this list, and those that are petrified by the survival horror genre can experience the immersive nature of The Sims series without any concerns. Curiously, The Sims 2 makes use of an "Aspiration Bar" system. This keeps tabs on the player's larger goals and their ability to realize these dreams, or if their behavior is counterintuitive to fulfillment. If the player strays too far and allows their Aspiration Bar to deplete, they'll go through a mental breakdown and hallucinate, seeing a therapist who attempts to recalibrate their mental state.

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