You have sensory experiences created by your mind. Choose or roll on the following table. When you experience this stimulus, you must succeed on a DC 5 + (IE) Wisdom check to recognize the stimulus as a hallucination. Even when recognized as such, the hallucination remains. While you can ignore it, you still experience a −(IE) penalty on Wisdom (Perception) checks with that sense while it persists.
Generate Random Hallucination

function displayRandomHallucination() { const hallucinations = [ "Auditory", "Auditory", "Auditory", "Auditory", "Auditory", "Auditory", "Gustatory", "Gustatory", "Olfactory", "Olfactory", "Olfactory", "Tactile", "Tactile", "Tactile", "Tactile", "Visual", "Visual", "Visual", "Visual", "Visual" ]; const randomIndex = Math.floor(Math.random() * hallucinations.length); document.getElementById("hallucination").innerHTML = "Random Hallucination: " + hallucinations[randomIndex]; }

• Auditory. You hear sounds, often voices speaking to you or illusory environmental sounds.
• Gustatory. You experience tastes that are often strange or unpleasant, like metallic tastes. If you have multiple traits, you may choose Seizures as one of them.
• Olfactory. You experience smells unrelated to your environment.
• Tactile. Your sense of touch/interoception causes false experiences, such as bugs crawling on your body or your organs moving inside you.
• Visual. You see things that aren’t there, such as objects, creatures, people, lights, or visual patterns.

Real-world Examples

Schizophrenia, Epilepsy

Assistive Options

The most helpful aid for those hallucinating is calm conversation with a trusted ally. A party member can use the help action to listen to you and let you know that you’re hallucinating. This will allow you to reroll the Wisdom check with advantage.

Magical Assistance

The True Seeing spell will counteract visual hallucinations for the duration.

You have experiences or beliefs that others do not share, but you absolutely believe them to be true. Choose or roll on the following table. If you have multiple traits, you may choose or roll another Delusion trait or Intrusive Thoughts as one or more of them.

Trait

function displayTrait() { const rand = Math.floor(Math.random() * 100) + 1; let trait; if (rand >= 1 && rand = 7 && rand = 12 && rand = 18 && rand = 23 && rand = 30 && rand = 38 && rand = 45 && rand = 49 && rand = 56 && rand = 66 && rand = 74 && rand = 76 && rand = 83 && rand = 89 && rand = 97 && rand = 99 && rand <= 100) { trait = "Quick-motion phenomenon"; } document.getElementById("trait").innerHTML = trait; }

• Atmosphere. Something feels wrong about your environment, but you can’t figure out what, yet the feeling is undeniable. Because of your heightened awareness, you have a +(IE) on Wisdom (Perception) checks but a −(IE) penalty on Wisdom (Insight) checks.
• Awareness. You are intensely aware of a particular experience unrelated to your current circumstances or condition. Because of the distraction, you have a −(IE) penalty on initiative rolls, attack rolls and ability checks made as reactions, and Wisdom (Perception) checks.
• Control. You believe that you are being controlled, physically or mentally, by an external force. This causes a −(IE) penalty to Wisdom (Insight) checks.
• Dysmorphopsia. Straight lines or edges appear to be wavy to you. This altered perception gives you a −(IE) penalty on ranged attack rolls with at least partial cover.
• Erotomantic. You believe that someone, usually a public figure, is in love with you. You have a −(IE) penalty on Wisdom (Insight) checks related to this person, and you plan and act according to this belief.
• Grandiose. You believe that you are greater in some way than you are and act accordingly. This may manifest in a belief that you have a relationship with a famous being, that you are a famous being (past or present), or that you have exceptional talents, abilities, or powers. Some examples may include believing you have abilities of a character level higher than you’ve achieved, magic or proficiencies, or another character class that you don’t have. You will act on such beliefs unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally.
• Ideas. You believe something fantastical to be true or that you are being affected by some kind of magic that is not in fact affecting you. The GM and player should discuss this and determine a specific belief. Depending on the belief, the game effects can vary widely, so find the trait that most closely reflects this belief, and adjust accordingly.
• Imposter. You believe that one or more important people in your life are imposters (actors playing the role of those people) and will act according to that belief. You will act on such beliefs unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally.
• Intensity. You have a belief that is real, but you put an unreal amount of importance on it, such as a minor vermin infestation that you believe to be catastrophic. You will act on such beliefs unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally.
• Jealousy. You believe that a friend or partner is betraying you. You will act on such beliefs unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally.
• Macropsia. Objects appear (IE) × 20% larger than they are in real life. You have a −(IE) penalty on all attack rolls.
• Macrosomatognosia. Your own body feels (IE) × 20% larger than it is. You have a −(IE) penalty on all Dexterity checks, including Dexterity-based melee attack rolls.
• Memory. Your memory of (IE) events that happened is drastically different from reality. This can be part of your character’s backstory or historical events. You are convinced that your memory is accurate, and any evidence to the contrary is clearly fake or has some other explanation. To recall accurate details, you have a −(IE × 3) penalty in all Intelligence (History) checks related to that and related events.
• Micropsia. Objects appear (IE) × 20% smaller than they really are. You have a −(IE) penalty on all attack rolls.
• Microsomatognosia. Your body feels (IE) × 20% smaller than it really is. You have a −(IE) penalty on all Dexterity checks, including Dexterity-based melee attack rolls.
• Pelopsia. Objects seem closer than they are. You have a −(IE) penalty on all attack rolls and Dexterity (Sleight of Hand) checks.
• Persecutory. You believe that a person or object is trying to harm or work against you. You will act on such beliefs unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally.
• Reference. You believe (IE) neutral environmental events or objects to have personal significance, that something is directed toward or connected to you when it isn’t. You will act on such beliefs unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally.
• Somatic. You believe that you are sick or disabled and experience a range of physical symptoms. You struggle to acknowledge the underlying mental health related reasons (i.e., stress, trauma, etc.) that are causing these symptoms. While they feel real to you, no physical or magical cause can be found. Choose or roll another trait and IE for the delusional trait. You will experience the penalties associated with that trait unless convinced by an ally against following a specific harmful course of action, either through roleplay or an opposed Charisma (Persuasion) check by the ally. You do not typically receive any associated benefits from that trait unless agreed upon by both the player and GM. If you have multiple traits, you may choose this trait multiple times, each with a different delusional trait.
• Teleopsia. Objects seem further away than they are. You have a −(IE) penalty on all attack rolls and Dexterity (Sleight of Hand) checks.
• Quick-motion phenomenon. Time seems to go much quicker than it really is, as if the surrounding world is under a Haste spell. You have a −(IE) penalty on all initiative rolls and Dexterity (Sleight of Hand) checks and Wisdom (Perception) checks to hear details.

Note that the Zone of Truth spell will not counteract Delusions, as the person experiencing the delusion genuinely believes what they are saying as related statements are not deliberate lies.

Real-world Examples

Alice in Wonderland Syndrome, Capgras Syndrome, Schizophrenia, Dementia, Epilepsy, Parkinson’s Disease, Bipolar Disorder, Traumatic Brain Injury, Briquet's Syndrome, De Clérambault's Syndrome

Assistive Options

Allies who have spent at least (7 − their Charisma modifier) days with you receive a +1 to Charisma (Persuasion) checks to help you cope with delusions by recognizing behavioral pattern changes.

Magical Assistance

The Zone of Truth spell can help you with delusions when creatively applied, giving you +2 to related saving throws to temporarily disbelieve the delusions.

You experience seizures. Choose or roll on the following table. If you remain aware and conscious during a seizure, you must succeed on a DC 8 + (IE) Constitution check to maintain concentration if needed.

function generateSeizure() { const rand = Math.floor(Math.random() * 100) + 1; let seizureType;

if (rand <= 40) { seizureType = "Focal Aware Seizures"; } else if (rand <= 60) { seizureType = "Focal Impaired Awareness Seizures"; } else if (rand <= 67) { seizureType = "Absence Seizures"; } else if (rand <= 77) { seizureType = "Myoclonic Seizures"; } else if (rand <= 82) { seizureType = "Clonic Seizures"; } else if (rand <= 88) { seizureType = "Tonic Seizures"; } else if (rand <= 93) { seizureType = "Atonic Seizures"; } else { seizureType = "Tonic Clonic Seizures"; } document.getElementById("seizureType").innerHTML = "Seizure Type: " + seizureType; }

• Focal Aware Seizures. You have a strange feeling for (IE)d20 seconds resulting in one of the following experiences.
  

  d8	Experience
  1	Nausea
  2	Unusual smell or taste: You smell or taste something with no known source. You have a −(IE) penalty on all Wisdom (Perception) checks related to smell and taste for the duration.
  3	Amplified Emotion (both kinds equally likely)
  4	Myoclonic Seizure in one random arm
  5	Numbness in one random limb
  6	Feeling like one random limb is larger or smaller than it actually is: you have a −(IE) penalty on all Dexterity attack rolls, ability checks, and saving throws with that limb for the duration.
  7	Perception of colored or flashing lights: You have a −(IE) penalty on all Wisdom (Perception) checks involving vision
  8	Hallucinations

• Focal Impaired Awareness Seizures. You become confused as if under the Confusion spell for (IE)d4 minutes.
• Absence Seizures. You become stunned and unaware of your surroundings for (IE)d4 seconds. You may carry on simple actions like walking, but you are unconscious as far as your mind and senses go.
• Myoclonic Seizures. Your muscles jerk (IE)d4 times, once every round. You have a −(IE) penalty on all Strength or Dexterity attack rolls, ability checks, and saving throws during a seizure and must succeed on a DC 5 + (IE) Dexterity saving throw or drop anything you’re holding in your hands. Any spell that you attempt to cast with a somatic component will fail but will not use your spell slot.
• Clonic Seizures. Your muscles have spasms that make your face, neck, and arm muscles jerk rhythmically. During this seizure, you have a −(IE × 2) penalty on all actions requiring the use of your arms and cannot cast spells requiring a somatic component. Casting a spell with a verbal component requires a successful DC 10 + (IE) Constitution check. Failure results in the spell failing, but it does not use a spell slot. Clonic Seizures last (IE)d6 rounds.
• Tonic Seizures. The muscles in your arms, legs, or trunk tense up. When this seizure begins, you must succeed on a DC 10 + (IE) Dexterity saving throw or become prone. On success, you must continue this check each round for the duration of the seizure. Your movement during the seizure is divided by the IE. Tonic Seizures last (IE)d4 rounds.
• Atonic Seizures. Your muscles suddenly become paralyzed, and you become prone. You must succeed on a DC 10 + (IE) Wisdom (Perception) saving throw to notice the onset of the seizure and to use an action to intentionally become prone. Failure results in falling and taking 2 (1d4) bludgeoning damage unless wearing a helmet. The seizure lasts (IE)d4 seconds, but you get (IE)d4 of them in a row with 1d4 rounds in between each of them.
• Tonic Clonic Seizures. Your body stiffens, jerks, and shakes, and you become unconscious. Sometimes you lose control of your bladder or bowels. This seizure lasts 1d(IE) × 2 minutes.

Real-world Examples

Epilepsy, Gray Matter Heterotopia, Traumatic Brain Injury, Lupus, Multiple Sclerosis

Assistive Options

Those with seizures benefit from someone watching them for the onset. A friend or ally nearby at the onset can use their action to help you, giving you advantage on checks against falling, bumping into something harmful, and other physical effects. You may also consult the section on Service Animals.