Effect | Code
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- All enemies have permanently feared
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- All floors have the basement room tile set
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- All items except troll bombs mimic Issac's movement
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- Character and tears turn black
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- Character leaves fecal trail
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- Character only visible as brown shadow
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- Character takes double damage
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- Concussive enemies that move randomly
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- Doors open immediately, tears are harmless; Boss's health act as timers
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- Eligible enemies become champions
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- Enemies become feared randomly
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- Enemies only visible as brown shadows
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- Enemies respawn when character leaves room; new items do not drop
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- Invisible character except for surrounding light effect
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- Large pools of blood when enemies die
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- Load screen always displays "Are You Sure You Want Me To Die?"
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- Pill names and descriptions appear as ???
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- Slow motion while character is idle; music speed altered with movement speed
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- Sound effects replaced with farts
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- Start with 69 coins and have to purchase all items and pickups
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- Tarot cards are face down when collected
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- The lower your health, the slower the music
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- Ticking starts every 45 seconds, after 5 seconds character takes half heart of damage
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