Silent Screams (5e Disease)

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Silent Screams[edit]

Contracting Silent Screams[edit]

Silent Screams is an illness common among people who are almost always in constant contact with something extraplanar; Planeswalkers, Monster Hunters, Warlocks, etc. It is a representation of their slowly deteriorating mind affecting their body, as their own thoughts turn on them. Warlocks of the Great Old Ones commonly die from this if they become too powerful, as the incomprehensible nature of their patron changes them beyond repair. If a creature is to become infected, they must first make a Sanity saving throw, DC 20.[1]


Stage 1: Initially, the patient simply would feel occasional minor headaches. However, as it slowly transitions into phase 2, the patient's headaches will become much more painful and will often be accompanied by small visual hallucinations and distortions, such as objects changing color or illusory shadows in the corner of their eye. They might feel illusions of grandeur, and could start to become irrational and almost erratic in their actions. However, this is just the start of the rabbit hole they're going to go down if they don't get treatment.

Stage 2: Around a day after symptoms start to occur, Stage 2 begins. During this stage, the symptoms become much more severe. For starters, the patient becomes completely mute, unable to speak verbally in any way. The patient's hallucinations are now also Auditory, such as voices and sounds that aren't there or sentences being altered. The patient's delusions also become much more severe, resulting in large amounts of Paranoia and Anxiety.

Stage 3: Stage 3 is often very rare among patients, although not impossible if not properly treated. It takes several days without any treatment at all for a patient to reach stage 3, but there is no going back once it has happened. During Stage 3, the headaches and hallucinations become so potent that they deal Psychic damage, and the patient is essentially a walking time bomb that is on its last few milliseconds. Pretty much anything will set them off into a violent rage, and almost nothing can stop it. This state is incurable, and will often lead to the patient's death.


Silent Screams can be cured with calm emotions or lesser restoration cast with a spell slot of 3rd level or higher.

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  1. If your DM isn't using the optional Sanity ability score, then Intelligence works just fine here.
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