- (* = Not Yet Overhauled)
When you fail a death saving throw you gain one level of exhaustion or madness, your choice.
Exhaustion and madness can be gained by enduring physical and mental punishment such as travelling for days without rest or seeing your loved ones slain. It can also be inflicted by the supernatural such as being the victim of a mummy's curse or an insanity spell.
1 Rank of Exhaustion can be lost over the course of a long rest in which the character also eats and drinks normally.
1 Rank of Madness can be lost by spending a day in comfortable circumstances without engaging in violence or stress.