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Message: <blockquote data-quote="abirdcall" data-source="post: 9496930" data-attributes="member: 6748898">We recently played Rime of the Frostmaiden which is a horror themed campaign.Only long rest in a friendly settlement.Weather conditions are encounters (eg. blizzard, -80 temp drop) which causes exhaustion. Added that 2 HD can be spent during short rest to remove 1 exhaustion.Mental stress effects which caused permanent changes to their character (usually how they respond to further stressful situations). Example: defeated by a hag she ate one of the PCs in front of them and then left them to deal with the horror. They had an option to take -1 to stats if they didn't like the RP stipulation.In general the world itself was harsh so even without changing the rules a lot it came off as harsh. Plot hooks were mostly vague rumours of a lost expedition or someone surviving seeing a horror. They had to travel to the adventure site and travel back so there was rising tension.Lots of random encounters which could mess things up. Even one where they get teleported and don't know where they are and are now in an entirely different plot.Limiting player knowledge makes things grittier and more uncertain.</blockquote>