Madness Table Alternatives

As some players may not be comfortable with the depictions of mental illnesses and other disabilities
in ​5​th edition, this is an alternative supplement I have created to try and remedy those issues while
still retaining the potentially serious effects of traumatic experiences on a player character (which are
significant aspects of some adventures, such as Out of the Abyss or Curse of Strahd).

Minor Trauma
Replacing ​short-term madness effects ​from the DMG, characters are subjected to the rolled effect
for ​1d10​ minutes.

d100  Effect (lasts 1d10 minutes) 

01-20  The character is rooted in place; their move speed becomes 0. This effect ends if the 
character takes damage or if another character spends an action to shake them out of it. 
21-35  The character is disoriented and cannot take any actions outside of movement. 
36-45  The character is significantly emotionally distressed, taking disadvantage on all Charisma 
based skill checks and saving throws. 
46-55  The character becomes nervous and starts trembling, taking disadvantage on Sleight of Hand 
checks and all ranged attacks. 
56-65  The character’s confidence is shaken, and they have disadvantage on Athletics checks, 
Acrobatics checks, and all melee attacks. 
66-75  The character’s fear becomes hesitation, and they take a 1d4 penalty to all ability checks and 
attack rolls. 
76-85  The character is dazed and subtracts 10 from their passive Wisdom (Perception and Insight), 
and cannot make Perception or Insight checks. 
86-95  The character becomes frightened and must use their movement each round to flee from the 
source of the fear. 
96-100  The character faints, falling unconscious. 

Major Trauma
Replacing ​long-term madness effects ​from the DMG, characters are subjected to the rolled effect
for ​1d10 x​ ​ 10​ hours.

d100  Effect (lasts 1d10 x 10 hours) 

01-20  The character is deeply rattled and can speak only falteringly, imposing disadvantage on any 
spell-related rolls for spells that require a verbal component. 
21-35  The character suffers frequent trembling which imposes disadvantage on attack rolls and 
saving throws using Strength or Dexterity. 
36-45  The character is badly shaken, and has disadvantage on all ability checks. 
 46-55  The character is unsettled enough to experience issues with focus and memory recall. They 
may not make any Intelligence based skill checks. 
56-65  The character becomes paranoid and fearful of what may lurk in the shadows. When not in 
bright light, a
​ ll​ ability checks and attack rolls are made at disadvantage. 
66-75  The character has become fatigued in response to their trauma, and their speed is halved. 
76-85  The character prefers to daydream rather than think about the trauma that has affected them. 
At the start of combat, the character must roll a Wisdom saving throw (DC 13), becoming 
surprised on a failure. 
86-95  The character regards something related to the source of their trauma with intense revulsion, 
as if affected by the antipathy effect of the ​antipathy/sympathy s​ pell. 
96-100  The character falls unconscious. They cannot be roused from their fitful sleep until the trauma 
effect ends, is cured, or until they have taken enough damage to go below 0 hit points, at 
which point they may wake as normal upon stabilization or a successful death save. 

Persistent Trauma
Replacing ​indefinite madness effects ​from the DMG, characters are subjected to the rolled
persistent trauma effect until magically cured or dispelled.
These effects are to be noted under the ‘Flaws’ section on a character’s sheet, as they are
permanent until magically cured. Effects in quotation marks should be directly copied onto a
character’s sheet; other effects should be relayed to the player to note down as they see fit, and their
effects should be kept track of by both the DM and the player.

d100  Effect (lasts until cured) 

01-15  You suffer from night terrors. On a long rest, you must roll a d6; on a 1, you do not gain the 
benefits of a long rest. You may instead roll hit dice as if taking a short rest. You recover spent 
spell slots and may prepare new spells. 
16-30  “I have overcorrected for my shaken confidence and now view myself with elevated self worth 
and forced bravado.” 
31-40  “I have significant difficulty letting go of or discarding things that may be important, no matter 
how insignificant others might consider them.” 
41-50  “I am extremely protective of those around me and worry constantly about the safety of my 
companions, likely to the point of annoyance at my fretting.” 
51-60  Your patience with others has worn somewhat thin. You have advantage on Intimidation and 
Deception checks, but disadvantage on all other Charisma-based checks, including saving 
throws. 
61-70  “I am hyper-aware of how others view me, and am desperate for approval and praise to help me 
cope with my shaken confidence.” 
71-80  “I try to keep mementos of who or what I’ve lost, no matter how odd, and become upset or 
enraged if someone suggests parting with them or tries to take them from me.” 
81-90  “I am reluctant to admit when I don’t know something, fearing the judgment of others. I 
 sometimes jump to make assumptions in an attempt to fill the gaps in my knowledge.” 
91-100  Your trauma has caused you to lose interest in something you were once passionate about. You 
are no longer proficient in a skill of your DM’s choice. 

Persistent Trauma Variant: Environmental Stress

This alternate table is to be substituted at the DM’s discretion in places that might additionally
magically affect or corrupt characters in ways resembling persistent trauma effects (alongside the
possibility of more mundane effects), such as faerzress-suffused areas of the Underdark, or the
Demiplane of Dread.

d100  Effect (lasts until cured) 

01-15  You suffer from night terrors. On a long rest, you must roll a d6; on a 1, you do not gain the 
benefits of a long rest. You may instead roll hit dice as if taking a short rest. You recover spent 
spell slots and may prepare new spells. 
16-30  “I often doubt aspects of my surroundings and am hypervigilant of anything that I think may not 
entirely be as it seems. I might believe that a ‘suspiciously empty-looking’ clearing likely contains 
invisible enemies, or that every chest, door, or doorframe I encounter is a mimic.” 
31-40  You have developed a significant fear of—or intense disgust or hatred for—some aspect of your 
surroundings at the time this stress took effect: for example, a type of beast. or a weather effect 
present at the time. 
41-50  “I no longer feel safe alone, and strongly prefer to be within 100 feet of others at all times.” 
51-60  “Whenever I hear of prophecies, omens, or similar such things, I assume they must be about me 
or my companions. After all, my situation has been strange enough already that it would be far 
stranger for them ​not t​ o concern me. Even the prophecies of the past are not out of the 
question—after all, chronomancy exists.” 
61-70  “The stress of my situation tends to cause me to lash out at others. Though I likely regret my 
actions later, in the moment, I am often obstinate and unwavering in my frustration.” 
71-80  “I have come to believe the gods are testing me and using me for entertainment, possibly even 
controlling my every move in a dice game. I might sometimes make sarcastic verbal asides to 
the gods I know must be watching me, or perhaps I carefully choose my words or actions in 
order to consciously manipulate the narrative I’ve found myself in.” 
81-90  “I have developed a mild to moderate fear of the passage of time and/or dread growing older. 
This often leads to impatience, as every second that passes is a second lost forever.” 
91-100  Your experiences have caused you to lose interest in something you were once passionate 
about. You are no longer proficient in a skill of your DM’s choice. 

Persistent Trauma Variant: Abyssal Corruption

This alternate table is to be used in circumstances wherein a character has a chance to become
magically corrupted or else subject to any kind of magical curse that might resemble a persistent
trauma effect, alongside the possibility of more mundane trauma—namely, the circumstances of
failing a save versus persistent trauma in the presence of a Demon Lord from the Abyss, although
the table may be used for other similar scenarios.

d100  Effect (lasts until cured) 

01-15  You suffer from night terrors. On a long rest, you must roll a d6; on a 1, you do not gain the 
benefits of a long rest. You may instead roll hit dice as if taking a short rest. You recover spent 
spell slots and may prepare new spells. 
16-30  “I find it extremely difficult to trust new people, regardless of how obviously helpful they may 
seem to my allies. I tend to assume any new creature I meet is probably hostile to me, even if 
they might be hiding it for the moment.” 
31-40  “My experiences have instilled in me a deep-seated dread for what may lurk in the shadows. I 
prefer to never linger in darkness and to always have a light nearby, and become agitated or 
upset if forced to get by without such a light.” 
41-50  “I no longer feel safe alone, and strongly prefer to be within 100 feet of others at all times.” 
51-60  Demon Lord specific: Refer to the relevant table below, and pick the first option for the 
associated Demon Lord. If not applicable, pick a below Demon Lord at random or reroll. 
61-70  “The stress of my situation tends to cause me to lash out at others. Though I likely regret my 
actions later, in the moment, I am often obstinate and unwavering in my frustration.” 
71-80  “I have overcorrected for my shaken confidence and now view myself with elevated self worth 
and forced bravado.” 
81-90  You have become convinced of the concept of predestination and an unchangeable fate. You 
might react with melancholy, apathy, anger, or acceptance, depending on your character. 
91-100  Demon Lord specific: Refer to the relevant table below, and pick the second option for the 
associated Demon Lord. If not applicable, pick a below Demon Lord at random or reroll. 

Demon Lord Specific Effects 

Certain Abyssal Corruption effects are specific to particular Demon Lords. These effects are as follows: 
 
Baphomet. O ​ n a 51-60, give the following Flaw to the affected character: “My anger often consumes me. I can’t 
be reasoned with once my rage has been incited.” 
On a 91-100, give the following Flaw to the affected character: “Hatred comes incredibly easily to me.” 
Demogorgon. O ​ n a 51-60, give the following Flaw to the affected character: “I can’t allow others to touch what 
belongs to me, or else they may take my possessions away.” 
On a 91-100, give the following Flaw to the affected character: “I am paranoid about potential plots to 
hurt or kill me from acquaintances and even allies.” 
Fraz-Urb’luu. O ​ n a 51-60, give the following Flaw to the affected character: “I never let others know the truth 
about my intentions or the reasoning behind my actions, even if doing so would be beneficial.” 
On a 91-100, give the following Flaw to the affected character: “I lie, obfuscate, or hide the truth when- 
ever possible because I believe I know what’s best for those around me, and sometimes lies are easier 
to take than the truth.” 
Graz’zt. ​On a 51-60, give the following Flaw to the affected character: “Anything that can bring me happiness 
should be enjoyed immediately. There is no point to saving things for later.” 
 On a 91-100, give the following Flaw to the affected character: “I tend to act impulsively and often  
without much consideration for social graces, frequently succumbing to my vices even at the risk 
of severe judgment from others.” 
Juiblex. ​On a 51-60, give the following Flaw to the affected character: “I refuse to part with any of my 
possessions, even if this would be beneficial to me.” 
On a 91-100, give the following Flaw to the affected character: “I must possess as many things as I can.” 
Orcus. ​On a 51-60, give the following Flaw to the affected character: “I want to achieve the everlasting existence 
of undeath.” 
On a 91-100, give the following Flaw to the affected character: “I am painfully aware of life’s futility.” 
Yeenoghu. O ​ n a 51-60, give the following Flaw to the affected character: “I get caught up in the flow of anger, 
and often try to stoke the anger of others around me.” 
On a 91-100, give the following Flaw to the affected character: “I far prefer action to careful planning, 
and am often starting fights or jumping into situations against the better judgment of others.” 
Zuggtmoy. ​On a 51-60, give the following Flaw to the affected character: “I have become hypochondriacal, and 
I’m constantly scratching at my skin due to concerns of fungal infections.” 
On a 91-100, give the following Flaw to the affected character: “I become distracted easily, often 
staring off into the distance for long stretches at a time.”