Sanity & Insanity

Surviving Asylum means keeping your mind together as well as your body. As your sanity falls, you progress through three tiers of insanity. Expect hallucinations, reversed controls, and a growing sense that your brain has officially handed in its notice.

Being in Blood Lust also negatively affects your sanity.

The Three Tiers of Insanity

• Tier 1: Unease — begins at around 69 sanity.

• Tier 2: Fraying — begins at around 49 sanity.

• Tier 3: Delirium — begins at around 24 sanity.

Psychotic Break & Mental Exhaustion

After progressing through all three tiers, reaching 0 sanity or below triggers a Psychotic Break.

This lasts a few seconds, after which you enter Mental Exhaustion. Monitor your sanity and try to restore it before reaching this point.

Insanity Effects

As insanity takes hold, you may experience:

• Audio hallucinations — hearing things that aren’t really there.

• Visual hallucinations — seeing things that aren’t really there.

• Reversed controls — your movement inputs are reversed, making it harder to control your character.

These are some of the possible effects, rather than a complete list. Don’t trust everything you see or hear.

Restoring Sanity

The following items add to your sanity pool:

• Cigarettes

• Calming Tea

• Sedatives

Keep a supply handy, particularly when heading out at night.

Killing a Zed also restores a small amount of sanity. Each kill only gives a little back, so keep other recovery options available.

Tobacco Leaves & Cigarettes

Tobacco leaves can be harvested from plants found in the world and crafted into cigarettes, which restore sanity.

Currently, tobacco can only be harvested from the world. Tobacco seeds are coming in a future update, allowing you to grow your own supply. They are not available yet.

Daytime, Traders & Claim Block Protection

Daytime, trader protection, and claim block protection help keep your sanity regulated.

Your claim block area provides sanity restoration, giving you somewhere to recover. However, if a Zed enters your claim block area, that restoration pauses.

If your sanity isn’t recovering at home, check the area and clear out any unwanted visitors.

Nighttime & Blood Lust

Sanity drains at night, and Blood Lust also has a negative effect on sanity.

Prepare before darkness falls by checking your sanity and stocking up on items that restore it. Heading into the dark with low sanity can push you further through the insanity tiers and towards a Psychotic Break.

Tips for Keeping Your Head Together

• Monitor your sanity and restore it before it drops into the lower tiers.

• Carry sanity-restoring items, especially during nighttime trips.

• Collect tobacco leaves while exploring so you can craft cigarettes.

• Use daytime, trader protection, and your claim block area to help regulate sanity.

• Keep your claim block area clear of Zeds so restoration can continue.

• Watch your sanity during Blood Lust.

• Don’t rely entirely on kills — each Zed restores only a small amount.

The Zeds want your brains. Try to keep yours functioning until they get there.