Fantasy lunacy...	-	-	-	... meets reality
-	-	-	-	Dragon 138

As a medical pathologist, I must often
consider how mental changes in patients
may have resulted from disease. In a similar
way, this article reviews the role of
insanity (actually, mental illness) in the
AD&D® game, showing how it can be an
appropriate part of an adventure game
and offering some practical ways to make
it playable.

Fantasy lunacy...


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Mental illness is a fairly common occurrence in fantasy fiction.

It appears in
Greek myths and in the epics of chivalry,
including the Arthurian cycles,
Ariosto’s “Orlando Furioso,” and
Spenser’s “The Faerie Queene.”
Mary Shelley’s Frankenstein
describes the emotional torment of
the original flesh golem.
Stephen Donaldson, the son of a physician, incorporated psychiatry’s insights into his contemporary adult fantasies,
The Chronicles of Thomas Covenant the Unbeliever. <see WHITE DWARF for AD&D stats>

Many things make AD&D game characters
go crazy. The indigo layers of prismatic
spheres, walls, and sprays cause
insanity unless saving throws vs. wands
are successful. Seeing a magic-user’s symbol
of insanity causes insanity (confusion in the PH), and so does
tasting an elixir of madness or being
attacked with a scarab of insanity. Mixing
types of magical eye-cusps or breathing
the spores of myconids will cause acute
psychosis. Very aberrant behaviors result
from using certain magical items like
tridents of yearning, chimes of hunger, or
eggs of desire. Gary Gygax suggests that
characters stranded for millennia on the
Astral plane might become insane (see
“The Astral Plane,” in DRAGON® issue #67,
page 29).

Depending on the campaign, insanity
could have other causes. Slight variations
of the symbol of insanity spell might produce
different symptoms. Other magicusers
may have researched new versions
of power word, eyebite or truename spells
that cause insanity. The clerical heal spell
cures most mental illnesses, so one use of
its reverse (harm) might be to cause them.
Certain bestow curse, cause disease, and
glyph applications by imaginative clerics
might cause brief mental illnesses. Illusionists
probably have spells to cause hallucinations
and delusions. (An illusionist using
a valuable moonstone in the chromatic orb
spell might cause lunacy.) The gaze of
Stephen Inniss's durocib familiar causes
insanity (DRAGON issue #86, page 21). So
might the bite or gaze attacks of certain
hordlings, demodands, slaadi, etc. Rogue
modrons may be insane, and Ssendam
calls himself "Lord of the Insane", whatever
that means. Clerics of Azathoth are
described as insane in the first edition of
the DDG cyclopedia.
The planes of Limbo may have many
insane inhabitants.

Nearly any creature in the AD&D game
can be affected by insanity. Kuo-toans are
especially vulnerable, and magical frustrations
can drive even elementals and aerial
servants crazy. However, creatures with
minds altogether unlike ours (creatures
from the Positive and Negative Material
planes, quasi-elementals, evil fungi, etc.)
might be immune to insanity, and unintelligent
creatures probably cannot go insane.
Devas, most hierarch modrons, and the
undead might never be affected. Very high
intelligence, wisdom, or charisma scores
might protect against some causes of
insanity. Serten's spell immunity could
offer some safety, and a mind blank spell
might provide immunity to certain forms
of acquired mental illness.

...meets reality
Elaborate rules explain the effects of mental illness; twenty types are listed on
pages 83-84 of the DMG, with the warning that the categories
are not clinically correct. Yet insanity
rarely appears in modules or gaming
articles (the last DRAGON Magazine article
on the subject was in issue #18), and I
have not personally seen this illness used
in any campaign. Why?
In our world, mental illness probably
causes more unhappiness than even
arthritis, heart disease, or cancer. Alcoholism
(dipsomania in the DMG) causes havoc
in one out of every three homes. Schizophrenia
(known by numerous names in
the DMG, including dementia praecox,
schizoid, hebephrenia, catatonia, hallucinatory
insanity, delusional insanity, and
paranoia) affects millions of people who
also lack adequate care. Schizophrenia
itself is confused in the DMG with multiple
personality, a different disorder which we
now know to occur in victims of child
abuse. Mental retardation (feeblemindedness)
affects many millions and has terrible
effects on families. In our complex
world, both adults and children are at risk
for depression (melancholia) and suicide
(suicidal mania). Mania, either alone or as
part of a manic-depressive cyclic disorder,

cripples perhaps one adult in every two
hundred. Even relatively minor problems
like compulsive stealing (kleptomania), fear
of public places (agoraphobia, surprisingly
omitted from the DMG), and eating disturbances
are major handicaps. And few
would argue that pathological lying, sadomasochism,
homicidal mania, or suicidal
mania (see also the magic-user spell
Leomund's lamentable belabourment) are
particularly fun to role-play.
The DMG is a monumental work, and
the AD&D game has brought enjoyment
into the lives of many people. But real
mental illness affects too many real people
and should not be a part of any game.
Insanity is very important in the CALL OF <Cthulu Mythos>
CTHULHU® game from Chaosium, Inc.,
but its creators selected kinds of insanity
described in H.P. Lovecraft?s fantasies, not

those from medical psychiatry or pop
psychology. The same thinking probably
led the originators of the AD&D game to
avoid clinical descriptions of physical

diseases. The elements of the DMG?s list
seldom reappear elsewhere (for example,
basidirond psychosis does not resemble
any of them).

The new system
When mental illness strikes a character,
it should take a form drawn from heroic
fiction, rather than one that may have
touched the life of a player. Most fictional
insanity involves the acquisition of single
fixed ideas and the behaviors that result;
insanity caused by magic should always be
of this type. If insanity is to be used in a
game, the simple options given in Table 1
are recommended. My experience suggests
that players find these easy and
enjoyable to role-play. Roll 1d12 for randomly
distributed results; otherwise,
select an appropriate result.

Exactly what the victim thinks about will
be determined by what was happening at
the time the insanity was acquired. No
amount of arguing will restore an

Table 1
Random Insanity Table (roll 1d12)
 
 

1.	Alter ego	The victim manifests a second personality, having the same alignment but otherwise as radically opposite to his normal personality as can be. The second personality will remain in control until the insanity is cured.
2.	Creature complex	The victim has the delusion of being a creature of an NPC race, usually a monster. His behavior will generally conform to the class of creature, though the victim will always be able to speak, move, and fight normally.
3.	Exaggerated fear	The victim is abnormally fearful of some creature or situation, and he will flee or cower whenever confronted by it. The victim will also ask about this creature or situation in any conversation.
4.	Exaggerated hatred	The victim conceives a loathing for some type of creature (not a character race or class) and will attack that creature without any reason or restraint. The victim raises the topic of that creature ?s existence in any conversation.
5.	Exaggerated liking	The victim conceives a strong affection for some kind of creature. He speaks of this creature whenever possible.
6.	Exaggerated suspicions	The victim suspects everyone of secretly being an enemy. He expresses his suspicions openly.
7.	Extreme suggestibility	The victim is very easily influenced by others and gets no saving throw vs. any charm, command, or suggestion spell. Even nonmagical suggestions require a check vs. wisdom on 1d20 or the victim immediately obeys all but self-destructive commands.
8.	Fantasy role	The victim thinks he has become some famous personage from myth or legend. The personage is not always powerful but is usually known to all local PCs as a ?myth.?
9.	Monty Haul syndrome	The victim is deluded that he is an unbelievably powerful character. Depending on the flavor of the campaign, the victim might be  the Emperor of Atlantis, 5,217th-level fighter-magic-user-thief,  the ki-rin queen,  or the like.  Gods and religious leaders might be inappropriate choices.
10.	Quixotism	The victim believes common objects to be wonders from heroic fantasy; a cheap inn is a palace, a washbowl is a magical helmet, windmills are evil cloud giants, etc. The victim will act accordingly with great enthusiasm.
11.	Visual hallucinations	The victim sees enemies that are not there. This happens in any combat situation or whenever a saving throw or ability check is required.
12.	DM's choice	The DM chooses from the above list or invents a type of fixation appropriate to the situation. The victim may openly and casually commit minor antisocial acts (localized arson or petty thievery), develop a peculiar craving (hang gliding, eating shrieker, owning an otyugh), or show an odd interest (alchemy for a fighter, archery for a cleric, dwarven history for a wood elf, etc.) Some groups enjoy rhyming or punning manias. Sexual aberrations are never appropriate choices.

insane person?s insight. However, several
basic rules set limits on the abnormal
behavior. Insane characters can speak,
move, and fight normally. They will not
leave the party ? even a victim of exaggerated
suspicions who has been forcibly
restrained will not desert his comrades. In
no case will alignment behavior or religious
faith be compromised, though lawful
types may feel the need for an atonement
when they recover.

Recognizing that another creature is
insane may be easy or difficult, depending
on the campaign and the DM?s judgment.
In our world, some psychotics are quite
convincing. Detect disease or ESP spells
may help, and so might defect balance or
psionic empathy or telepathy, Once a
character is recognized as insane, he
receives an automatic -50% on most
reaction dice, and no one will place any
confidence in such victims, especially
those with creature complex or Monty
Haul syndrome. Needless to say, goodaligned
party members should never allow
an insane comrade to be humiliated,
injured, or abandoned ? perhaps an
adventure in itself.

Using this system in practice, suppose
the PCs are mind-blasted twice by hidden
mind flayers, then attacked by wererats.
The forms of insanity listed in Table 1
herein might affect a male dwarven fighter
in the following ways:

1. The dwarf announces that he is an
elven magic-user princess. He shaves his
beard, looks for elven clothing for females,
and blames his (constant) spell failures on
magic resistance, magnetic forces, hostile
dwarves, or whatever.

2. The dwarf announces he is a giant rat.
He travels on all fours and occasionally
squeaks. He tells everyone he meets about
being a rat, then asks them for cheese.

3. The dwarf is suddenly terrified of all
rats. He climbs on an elf?s shoulders in
dungeons to be safe. He tactlessly inquires
about rats when seeking night lodgings. If
any real rats appear, he flees screaming.

4. The dwarf starts making side trips to
exterminate underdark rats, and soon
buys larger and more dangerous weaponry
with which to exterminate all rats everywhere.

5. The dwarf starts catching and taming
rats. He shows his new pets to every stranger
and starts a huge rat collection,

6. The dwarf starts accusing everyone
else of conspiring with ?those rats? to
subvert everything decent and good.

7. The dwarf become uncharacteristically
cooperative and tractable, and often
obeys even the most stupid suggestions,
such as ?Go soak your head.?

8. The dwarf starts introducing himself
as the Pied Piper of Hamelin and offering
his services. He buys a flute, which he
plays (badly) while dancing (badly) whenever
he meets rats.

9. The dwarf starts introducing himself
as ?Lord Rodent Ratslayer, King of the
Multiverse, Boss of the Underdark.? He
gives orders to other PCs and literally
laughs in the face of terrifying danger
with absurd self-confidence.

10. The dwarf, whenever he becomes
excited, attacks rocks and stalagmites,
calling them ?the giant rat Bubonus and its
filthy minions.?

11. The dwarf sees rats that aren?t there.
This happens during any hostile encounter,
as well as when he stumbles, gets
tired, and so forth. He attacks the ?rats? in
preference to any other opponents.

12. The DM has a choice and will take
into consideration both the character of
the dwarf and the personality of the player
(?I must find . . . a shrubbery!? ).

The insanity table is referred to in the

DMG?s section on psionic blast effects on
nonpsionic creatures (page 78). These
rules are cumbersome, and the attack
results for a creature of a given intelligence
and wisdom are too predictable. It is
especially easy to kill creatures of animal
intelligence; characters with wisdom and
intelligence sums in the 30-33 range are
typically feebleminded by the first psionic
blast and killed by the second. These rules
are fun-spoilers.
The following is a new way to determine
the results of psionic blasts on nonpsionic
beings. For each such attack, roll 1d20 and
add the result (plus bonuses) to the victim
?s intelligence. The sum determines the
result on Table 2 of this article.
Insanity caused by a psionic blast strikes
as soon as a current combat situation
ends. Cavaliers and paladins, who are
relatively immune to certain mental
attacks, are allowed to retain 90% immunity
to such insanity. Monks from the
Players Handbook gain the bonuses given
them on page 31 of that text. DMs may
also want to add other DMG modifiers.
One advantage to this system is the ease
to which it can be adapted on a character
sheet. Thus, for a human fighter with
intelligence 6, the following applies:

Roll Result
15+ No effect
13-14 Temporary insanity
11-12 Permanent insanity
9-10 Rage
7-8 Attack nearest creature
5-6 Panic
3-4 Stun
2 or less Coma

Table 2
Effects of Psionic Blasts on Nonpsionic Beings

Sum	Result
21 +	No effect
19-20	Temporary insanity (lasting one day per point of attack strength)
17-18	Permanent insanity
15-16	Rage (attacks own party if no opponents are available; lasts one round per point of attack strength)
13-14	Attacks nearest creature with weapon or spell (lasts one round per point of attack strength)
11-12	Panic (runs away; lasts one round per point of attack strength)
9-10	Stun (no attacks, -4 to AC and saving throws; lasts one round per point of attack strength)
7-8	Coma (but clearly alive; lasts one day per point of attack strength)
6 or less	Dead (automatically at -10 hp)
Bonuses	-
+ 4	Dwarf, gnome, halfling, or dragon; Serten’s spell immunity magic-user spell
+ 2	Elf or cleric
+1 to +4	High wisdom (15-18) bonus
- 1 t o - 3	Low wisdom (7-3) penalty
- 2	Surprised
- 4	Kuo-toan
Others	DM?s judgment; see DMG, page 78, ?Saving Throw Dice Adjustments?
Immune	Charmed or insane characters; characters already affected by mind blast; nonpsionic devas, modrons, and undead; all golems; mind blank magic-user spell, amulet of life protection

Whether or not psionics are retained in
the rules revision, psionic blasts should
remain as the mind-flayer and sumonster’s
distinctive attacks. Depending
on the campaign, a psionic blast of any
strength might affect a nonpsionic being,
and the number of such attacks delivered
per round or surprise segment could be
limited to one.

Curing insanity
Clerics give good counsel and — better
yet — they heal. A shukenja’s calm cures
temporary insanity and might quiet all
crazy people for a while. Cure diseases
might help in some campaigns. Heal is the
usual remedy for most forms of insanity
and could probably reverse the effects of a
psionic blast. The DMG (page 42) says that
heal will not cure serious mental disorders
not related to spells or inflicted by injury
to the brain; however, restoration cures
any and all forms of insanity (DMG, page
43), and a shukenja might cast restore
spirit for similar results.
Using restoration to cure insanity would
age a cleric three years. An alternative is
suggested by the D&D game rules, which
specify that casting restoration to restore
a drained level temporarily drains the
caster of one level, without unnatural
aging. Instead of being aged, the cleric
curing a particularly virulent mental illness
might briefly acquire the patient’s
insanity.
Insanity caused by casting contact other
plane should be very hard to cure, so that

magic-users will not rely on helpful clerics
every time they cast this spell. Restoration
should be required, and the cleric’s illness
should last for a number of days equal to
the distance to the plane contacted. The
cleric could adjust his fee accordingly.
The spell cure insanity exists in various
unofficial forms in many game campaigns.
Different DMs may place it at different
spell levels and may require various material
components, etc., depending on the
innate curative powers of the spell. Its
powers may overlap with exorcism in the
AD&D game and with dispel evil in the
D&D game.

Cure Insanity (Necromantic) Reversible
Level: 4 Components: V,S
Range: Touch CT: 1 round
Duration: Perm. ST: None
AE: Creature touched
Explanation/Description: This spell
immediately curses insanity due to most
causes. The spell must be administered
while the patient is exhibiting insane
symptoms. It can also heal one conscious
victim of the effects of psionic blasts,
hallucination-causing spores, or a confusion
spell. It will calm a river spirit-folk
character (from Oriental Adventures)
during flood time. The spell will not cure
insanity brought about by casting a contact
other plane spell, nor will it control
behaviors caused by lycanthropy. The
reverse, cause insanity, requires a touch,
and a saving throw vs. spells (with wisdom

bonuses) is allowed. Victims roll on the
Random Insanity Table herein, or the DM
selects an appropriately bizarre response.
Certain lawful-good clerics might gain
cure insanity as a second-level spell.
Druids are devoted to preserving the
balance (both natural and mental), and
they gain the spell at third level. Devas can
cast it once daily, and other great minions
of good can use it even more often. The
spell may damage or dispel certain creatures
of Limbo, as the DM decides. Some
chaotic clerics, such as those dedicated to
Azathoth or Ssendam, gain cause insanity
as a second-level spell. Tribal spell-casters
can gain the spell normally in either form.
Referees can invent other magical items
related to insanity. Certain cursed books
can cause it in any reader; beneficial
books can describe methods of detecting
and curing it. A charge from a staff of
curing might help a crazy person, and a
cure insanity potion would be worth 300
xp and 500 gp. Scrolls of protection from
insanity might require slaad blood for
their manufacture. Perhaps the party will
find a couch of counseling on which the
reclining victim can ventilate his deepest
emotions and thus be cured.
Mental illness in the AD&D game should
be very different from its form in our
world, both in symptoms and curability. To
enjoy playing nutty characters, the madness
must fit the environment.