The following are derangements that can be taken by Malkavians or other characters who suffer from derangements.
The V20 and Clanbook: Malkavian derangements are game-legal and canon (or ex-canon) whilst the final sections are custom-created for game play based on real-life known derangements & disorders. As always, the Storyteller should be consulted for final approval as some derangements can quickly derail a game.
V20 Official Derangements
Bipolar Disorder
Bipolar individuals suffer from severe mood swings, sometimes resulting from severe trauma or anxiety. Victims may be upbeat and confident one moment, then uncontrollably lethargic and pessimistic the next.
Kindred with this derangement are constantly on a hair trigger, never knowing when the next mood swing will strike. Whenever the vampire fails a task, the Storyteller has the option of secretly making a Willpower roll (difficulty 8) for the character. If the character fails the roll, she lapses into depression. Additionally, the vampire will go into depression whenever one of her rolls is botched, or if her blood pool ever drops below 2. The Storyteller should roll a die to determine how many scenes the character remains depressed, keeping the number a secret.
Vampires in a depressive state have their Willpower ratings halved (minimum 1). In addition, the vampire may not access her blood pool to raise Attributes. Upon emerging from the depressive state, the character is energetic, relentlessly upbeat and active (obsessively so) for a number of scenes proportionate to the time spent in depression. When a vampire is in this manic state, the difficulty of all rolls to resist frenzy is raised by one.
Bulimia
Individuals with bulimia assuage their guilt and insecurity by indulging in activities that comfort them — in this case, consuming food. A bulimic will eat tremendous amounts of food when subjected to stress, then empty her stomach through drastic measures so she can eat still more. In the case of vampires with this derangement, the need to feed is a means of relieving the fear and anxiety endemic to the World of Darkness. A bulimic vampire may feed four or more times a night — gorging herself, burning the blood in pointless (or not so pointless) activity, then starting the cycle again.
A vampire with bulimia gets hungry much more quickly than other vampires do. When feeding, a bulimic vampire must make a Conscience or Conviction roll (difficulty 7). If she fails the roll, she feeds until her blood pool is full, whether the vampire needs the extra blood or not. A vampire who is forcibly kept from feeding risks frenzy (make a frenzy roll, difficulty 6). The difficulty increases by one forevery 15 minutes that she is prevented from drinking.
Fugue
Victims suffering from fugue experience “blackouts” and loss of memory. When subjected to stress, the individual begins a specific, rigid set of behaviors to remove the stressful symptoms. This differs from multiple personalities, as the individual in the grip of a fugue has no separate personality, but is on a form of “autopilot” similar to sleepwalking.
Kindred suffering from this derangement require a Willpower roll when subjected to extreme stress or pressure (difficulty 8). If the roll fails, the player must roleplay her character’s trancelike state; otherwise, control of the character passes to the Storyteller for a number of scenes determined by the roll of a die. During this period, the Storyteller may have the character act as she sees fit to remove the source of the stress. At the end of the fugue, the character “regains consciousness” with no memory of her actions.
Hysteria
A person in the grip of hysteria is unable to control her emotions, suffering severe mood swings and violent fits when subjected to stress or anxiety.
Hysterical Kindred must make frenzy checks whenever subjected to stress or pressure. The difficulties of these rolls are normally 6, increasing to 8 if the stress is sudden or especially severe. Additionally, any action that results in a botch causes the vampire to frenzy automatically.
Megalomania
Individuals with this derangement are obsessed with accumulating power and wealth, salving their insecurities by becoming the most potent individuals in their environment. Such individuals are invariably arrogant and supremely sure of their abilities, convinced of their own inherent superiority. The means of achieving their status can take many forms, from devious conspiracies to outright brutality. Any individual of equal or higher status than the victim is perceived to be “competition.”
Kindred with this derangement constantly struggle to rise to the height of power and influence, by whatever means necessary. In a megalomaniac’s view, there are only two classes of people: those who are weaker, and those who do not deserve the power they have and must be made weaker. This belief extends to everyone around the vampire, including members of her own coterie. This derangement lends an extra die to all of the victim’s Willpower rolls, due to her towering sense of superiority. If a megalomaniacal vampire is presented with a realistic chance to diablerize a more potent Kindred, she will be sorely tempted. A Willpower roll (difficulty 9) is needed for the vampire to avoid taking “what is rightfully hers.”
Dissociative Personality Disorder
The trauma that spawns this derangement fractures the victim’s personality into one or more additional personas, allowing the victim to deny her trauma or any actions the trauma causes by placing the blame on “someone else.” Each personality is created to respond to certain emotional stimuli — an abused person might develop a tough-as-nails survivor personality, create a “protector,” or even become a murderer in order to deny the abuse she is suffering. In most cases, none of the personalities is aware of the others, and they come and go through the victim’s mind in response to specific situations or conditions.
When a vampire suffers this derangement, the Storyteller and the player must agree upon how many and what kind of personalities develop, and the situations that trigger their dominance in the victim. Each personality should be relevant to the trauma that causes it. Not only is each personality distinct, but in the case of Kindred, the different personalities might believe themselves to be from different Clans and sires. Kindred with multiple personalities can manifest different statistics for each of their personalities, but it is the Storyteller’s responsibility to determine the specific details.
Obsessive-Compulsive
The trauma, guilt, or inner conflict that causes this derangement forces the individual to focus nearly all of her attention and energy onto a single repetitive behavior or action. Obsession relates to an individual’s desire to control her environment — keeping clean, keeping an area quiet and peaceful, or keeping undesirable individuals from an area, for example. A compulsion is an action or set of actions that an individual is driven to perform to soothe her anxieties: for example, placing objects in an exact order, or feeding from a mortal in a precise, ritualistic fashion.
Vampires with an obsessive-compulsive derangement must determine a set of specific actions or behaviors, as described above, and follow them to the exclusion of all else. The effects of obsessive-compulsive behavior can be negated for the course of one scene by spending a temporary Willpower point. The difficulty of any attempt to coerce or Dominate a vampire into ceasing her behavior is raised by one. If a vampire is forcibly prevented from adhering to her derangement, she automatically frenzies.
Paranoia
The victim of paranoia believes that her misery and insecurity stem from external persecution and hostility. Paranoid individuals obsess about their persecution complexes, often creating vast and intricate conspiracy theories to explain who is tormenting them and why. Anyone or anything perceived to be “one of them” is often subjected to violence.
Kindred who suffer from paranoia have difficulty with social interaction; the difficulties of all dice rolls involving interaction are increased by one. They are distrustful and suspicious of everyone, even their own blood-bound progeny. The slightest hint of suspicious behavior is enough to provoke a frenzy roll, with the difficulty relative to the degree of the behavior. This paranoia may even extend to complex and rigorous feeding practices, to keep “them” from contaminating the vampire’s food supply.
Sanguinary Animism
This derangement is unique to the Kindred, a response to vampires’ deep-seated guilt regarding the act of feeding on the blood of mortals. Kindred with this derangement believe that they do not merely consume victims’ blood, but their souls as well, which are then made a part of the vampire’s consciousness. In the hours after feeding, the vampire hears the voice of her victim inside her head and feels a tirade of “memories” from the victim’s mind — all created by the vampire’s subconscious. In extreme cases, this sense of possession can drive a Kindred to carry out actions on behalf of her victims. Diablerie would be particularly unwise for an animist. Whenever a vampire with this derangement feeds on a mortal, a Willpower roll is needed (difficulty 6, or 9 if she drains the mortal to the point of death). If the roll succeeds, she is tormented by the “memories” of the person whose soul she has partially consumed, but is still able to function normally. If the roll fails, then the images in her mind are so strong that it is akin to having a second personality inside her, an angry and reproachful personality that seeks to cause harm to the vampire and her associates. The player must roleplay this state as if the mind of her victim in control. During the moments just before dawn, control reverts to the vampire.
Schizophrenia
Conflicting, unresolveable sets of feelings and impulses can cause a victim to develop schizophrenia, which manifests as a withdrawal from reality, violent changes in behavior, and hallucinations. Roleplaying this derangement requires careful thought, because the player must determine a general set of behaviors relevant to the trauma that caused the derangement. The hallucinations, bizarre behavior, and unseen voices stem from a terrible inner conflict that the individual cannot resolve. The player needs to establish a firm idea of what that conflict is and then rationalize what kind of behavior this conflict will cause.
Kindred with this derangement are unpredictable and dangerous. In situations that trigger a vampire’s inner conflict, the difficulties of all rolls to resist or direct frenzy increase by three, and the vampire loses three dice from all Willpower rolls.
Clanbook: Malkavian (Revised)
Desensitization
The vampire with this affliction is a virtual emotional amputee. As a derangement, desensitization inhibits the vampire's ability to feel any sort of strong emotion whatsoever, whetehr joy, sadness, anger or love. The afflicted just can't make the appropriate neural connections. The power of Dominate or the blood bond can still hold a vampire so afflicted in check, but even though such supernatural compulsion governs the vampire's actions, it has less of an effect on her psyche. Even when blood bound, the vampire goes through the motions of love and devotion like a distracted actor half-heartedly playing a part. She will still throw herself in front of a car to save her "loved one" but will do so without so much as a word, tear or a smile. When she frenzies, she does so in a chillingly silent paroxysm of violence; when struck with Rotschreck, she scuttles away like a cockroach instinctively fleeing the light. Vampires with this derangement find it difficult to truly believe in their own ideals, and so make all Humanity, Path, Conscience or Conviction rolls at +2 difficulty. They also suffer a 1-die penalty to any Social dice pools that require some show of emotion or warmth.
Disassociative Blood-Spending
This afflcition inhibits a vampire's conscious control over his own vitae. Vampires with this derangement have a tendency to unconciously spend blood points to raise their Attributes at unusual and inappropriate times - increasing their strength in the middle of a round of drinks, upping their reaction speed while trying to compose a letter, and so on. These vampires have even been known to spend blood points during the day while they sleep, waking up hungrier than usual and never knowing why. Once per session the Storyteller can rukle that the vamnpire has just spent a blood point to raise a given Attribute or wakes up an extra blood point low - oor even tell her her character's missing a blood point without elaborating when and where the point was spent or what for.
Masochism
A person with this derangement closely associates pain with pleasure. In vampires, who no longer enjoy sex in its own right, masochism tends to be linked to the pleasure received by drinking blood or receiving the Kiss. Masochism is usually linked to deep feelings of shame, and masochistic vampires have a tendency to be repulsed by the actual process of feeding from mortals. They are only fulfilled when they're suffering, presumably as some form of penance for the pleasure they feel when feeding. Vampires with this derangement begin to have difficulty operating when they become wounded. Once a masochistic vampire drops below the Bruised health level, he must make a Willpower roll (difficulty 6); failure indicates that he takes no action next turn, instead delighting in the sensation of pain. Furthermore, the masochist must make a Self-Control roll (difficulty 8), in order to use blood points to heal himself, no matter how terrible his injuries.
Memory Lapses
The vampire tends to lose random portions of her memory at inopportune times. The memories fade in and out, and can return as quickly as within a few minutes, or they might not come back for decades. At least once per scene, the vampire suffering from memory lapses will forget something relevant for a time. This might be as simple as forgetting where she left her keys (which can be a real problem when you're locked out of your haven close to sunrise), or as complicated as forgetting an entire Ability - and even that she once had that skill ("why are you looking at me like that? I've never touched a keyboard before in my life.") The player can ad-lib minor memory lapses as they come along, but Storyteller discretion is required to determine when and what to forget that will be dramatically appropriate.
Power-Object Fixation
The vampire afflicted with this derangement has invested much of her self-confidence in an external object, to the point where she believes she cannot function properly without its presence. Such a derangement is often linked to some past trauma in which the object played a major role - although not always in the obvious way. For instance an individual might focus on the belt her father beat her with as her source of strength, or a victim fixate on his dead fiancée's engagement ring if his hand was the only source of comfort during hard years. Victims of this fixation lose two dice from all their dice pools if somehow separated from their object of focus. It is hard to hide this fixation from observers; in times of stress, the vampire must make a Willpower roll to avoid cradling the object to her torso, rubbing it obsessively or otherwise physically comforting herself with its presence. This derangement sometimes spawns other related derangements over time - for instance the aforementioned abuse victim might develop a bullying personality much like her father's.
Regression
When confronted with stressful situations, a character with this derangement has a tendency to mentally revert back to a childlike state. Regressives are notable for poor senses of cause and effect, flawed interpretations of morality, and a general tendency to avoid confrontation. Regressive vampires continue to think of themselves as the same people they always are. Of course, they're notably much more self-centered fearful of the unknown, and reliant on strong "parent" figures, but this is a nuance that the vampire in question tends to miss. Vampires with this derangement are at a permanent +2 difficulty on all Self-Control/Instinct rolls; children have very little sense of discipline for the sake of discipline, and aren't sufficiently self-aware to master their own Beasts. The regressive is no different. When properly played, a regressive is terrifying - a supernatural creature with no real sense of right or wrong.
Self-Annihilation Impulse
The afflicted vampire feels a deep sense of revulsion for his flesh, and is literally terrified of the thought of "living" forever,. This revulsion is entirely unconscious, however; on a conscious level the vampire is totally unaware of his "death wish" although he may demonstrate a morbid streak,. Wheenver the character is confronted with more-or-less direct evidence of his immortality - such as visiting the churchyard where his mortal family is buried - he must make an immediate Willpower roll, or begin to undertake some sort of potentially deadly behaviour. This may be as direct as storming into Elysium and giving the Prince a piece of his mind, or might be more subtle such as breaching the Masquerade by talking to a reporter. In any event, the pursuit of self-destruction is not a conscious decision and not open for debate. the character will doggedly go about his "chosen" task until it's completed, resisting any attempts to talk him out of it. He may even conciously believe that the actions he's undertaking are perfectly safe. The compulsive behaviour lasts for one scene or so, but the consequences can last a lot longer.
Synesthesia
The afflicted vampire's sensory input is somewhat "scrambled"; although he's still capable of receiving sensory information, the information each sense provides is processed in terms of a different sense. The synesthetic "hears" colours, "smells" textures, "tastes" sounds and the like and is hard-pressed to think of such stimuli in any other fashion. Whilst the synesthetic is accustomed to the unusual sensory input, his problem lies in communicating what he senses to others; having difficulty expressig concepts such as "cut the red wire" more likely saying "cut the sandpapery wire" - and has difficulties comprehending speech from others. There's not even any guarantee that another synesthetic would be able to understand the vampire. Apart from the aforementioned communications difficulties, the synesthetic receives a +2 difficulty to any Expression and Performance rolls that don't involve creating purely surreal art, poetry or the like. The synesthetic may spend a Willpower point to correlate her sensory input in a "normal" fashion for a turn - or at least to be able to communicate normally by focusing just enough to associate that spicy smell he hears is what other people call "ringing."
Real World Derangements (Custom)
Anomic Aphasia
Anomic aphasia applies to persons who are left with a persistent inability to supply the words for the very things they want to talk about, particularly the significant nouns and verbs. Their speech is fluent and grammatically correct but it is full of vague words (such as ‘thing’) and circumlocutions (attempts to describe the word they are trying to find). In their mind and thoughts they clearly know what they want to say but the actual words elude them when they try to vocalise it, a feeling often like that of having the word on the tip of one’s tongue, which results in their speech having lots of expressions of frustration. People with anomic aphasia understand speech well and they can repeat words and sentences. In most cases they can read adequately. Difficulty finding words is as evident in writing as it is in speech.
Apart from the aforementioned communications difficulties, vampires with this derangement receive a +2 difficulty to any Expression and Performance rolls where impaired ability to vocalise significant nouns and verbs can determine comprehension or impact of what they are saying (to a max difficulty of 9). On a botched skill check affected by this difficulty, the vampire's frustration and inability to properly vocalise their thoughts causes so much frustration that they must immediately make a Self-Control/Instincts check (difficulty varies on importance of what is being vocalised, 4 for unimportant casual conversation, 6 for standard, and 8 for important details). The vampire may spend a Willpower point to focus her language skills input into a ""normal"" fashion for a turn - or at least to be able to communicate normally by focusing just enough to be understood properly, though this is mentally exhausting.
Antisocial Personality Disorder
People with this disorder are not necessarily shy or reclusive, or lack social skills, they are usually domineering and even aggressive. People with this disorder sufffer from a lack of compassion, empathy and conscience.The person simply does not care for anyone but himself, and places his own needs and wants above that of others. People with this will casually lie, cheat, steal, maybe rape and kill. People with this disorder are capable of making moral distinctions, they just don't care.
Avoidant
Beings with this condition feel inadequate, avoid social situations and seek isolation. They fear rejection and social humiliation. They prefer routine and exaggerate the potential difficulties of new situations to rationalize avoiding them. Some display an imaginative bent, creating fantasy worlds in which they are dominant, loved or triumphant. They yearn for social relations yet feel unable to obtain them. They are frequently depressed and have low self-confidence.
Borderline
Beings with borderline personality suffer from mood instability and low self-image. Constant, sudden mood swings and bouts of anger characterize sufferers of this disability, particularly when frustrated. Borderline victims sometimes take out their anger on themselves, masochistically inflicting injury or even trying to kill themselves. They think in very black-and-white terms and often form intense, conflict-ridden relationships.
Dependent
Beings with this disorder are needy and helpless. People with this condition can't stand being alone or acting on their own. They cling to others and fear losing them, often jumping from relaionship to relationship, even abusive ones. They are overly sensitive to disapproval and may break down, even to the point of suicide when faced with rejection. They let others make important decisions for them.
Depersonalization-Derealization Disorder
Depersonalization-derealization disorder (DPDR) is a dissociative disorder that involves individuals experiencing an ongoing or episodic sense of detachment or being outside of themselves — observing their actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around the individual may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization). Symptoms, which can be profoundly distressing, may last only a few moments or last extended periods.
Kindred suffering from this derangement must make a Willpower roll when subjected to anxiety, stress or pressure. The difficulties of these rolls are normally 6, increasing to 8 if the stress is sudden or especially severe. The player cannot spend Willpower to automatically succeed in this roll. If the roll fails, the character find it difficult to recognise others, remember things, communicate or coordinate her actions, receiving a +2 difficulty to all die rolls. Any actions with a difficulty higher than the player's current willpower can only be attempted with the expenditure of a Willpower point to focus the character's efforts. A small benefit, however, is that the dissociation grants the player a -2 difficulty to any Self-Control or Courage checks made as it is hard to properly associate threats or stimulus with the individual. The dissociative episode lasts until actions are taken by the character or her allies to calm the character (with an Empathy check at the same difficulty) or remove the source of the stress, either of which allows the character to re-attempt her Willpower roll. Success allows the character to regain her sense of self, although she “regains consciousness” with only dream-like recollection of her actions and circumstances.
Depression
Depressed individuals suffer from sorrow, lethargy and motivation problems, sometimes resulting from severe trauma or anxiety. Whenever the vampire rises for the night or fails a task, the Storyteller has the option of secretly making a Willpower roll (difficulty 8) for the character. If the character fails the roll, she lapses into depression. Additionally, the vampire will go into depression whenever one of her rolls is botched, or if her blood pool ever drops below 2. The Storyteller should roll a die to determine how many scenes the character remains depressed, keeping the number a secret.
Vampires in a depressive state have their current Willpower ratings halved (minimum 1) and any rolls for actions not directly related to the vampire's nature have the difficulty increased by one. In addition, the vampire may not access her blood pool to raise Attributes. As a minor benefit, when a vampire is in this depressive state, the difficulty of all rolls to resist frenzy is reduced by one.
Histrionic
Beings with this disorder need to be the center of attention all the time, often interrupting others in order to dominate conversations. They use florid language even when describing mundane events, and they seek constant praise. They may dress provocatively or exaggerate injuries in order to gain attention. They inflate social relationships, believing everyone loves them, describing casual acquaintances as "dear friends." They need to be adored and manipulate others to provoke this result. Nothing infuriates them more than being ignored.
Narcissistic
Narcissists are characterized by self-centeredness. As with histrionic disorder, people with this condition seek attention and praise. They grossly exaggerate and distort their accomplishments, expecting others to acknowledge them as superior. They tend to be choosy about picking friends, since they believe that not just anyone is worthy of them. They tend to make good first impressions, yet have difficulty maintaining long-lasting relationships. They are generally uninterested in the feelings of others and may take advantage of them.
Schizoid
Beings with this disorder not only have a difficult time with interaction, they prefer it that way. They genuinely choose to be alone and do not secretly wish for popularity. They tend to seek jobs that require little social contact. Their social skills are often weak and they do not show a need for attention or acceptance. They are perceived as humourless and distant and often are termed "loners."
Schizotypal
A lesser form of Schizophrenia, this is characterized by odd forms of thinking and perceiving. Individuals often seek isolation from others, have difficulty concentrating for long periods of time, and engage in "conspiracy theory" behaviour. Their speech patterns are convoluted, sometimes nearly nonsensical, with a free-association style of thoughts juxtaposed. Schizotypal speech is not as incoherent as schizophrenic "word salad," but jarring nonetheless.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is a pattern of constant worry and anxiety over many different activities and events. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks.
Kindred with GAD suffer a -1 penalty to any tasks that require extended concentration and must make a Willpower check whenever subjected to stress or pressure or fall into Torpor. The difficulties of these rolls are normally 6, increasing to 8 if the stress is sudden or especially severe. A kindred in GAD -afflicted Torpor is entitled to an Awakening roll after a number of minutes equal to a die roll, or if endangered on a Perception+Auspex (difficulty 8) check. A botch on the Awakening roll means that the kindred falls into deep sleep for the remainder of the night. Torpid Kindred always automatically awaken just before sunrise and may be awoken by others if fed a blood point.
Additionally, any Willpower check that results in a botch causes the vampire to frenzy automatically.
Grandiose Delusions
Grandiose Delusions occur in patients suffering from a wide range of mental illnesses, including two-thirds of patients in manic state of bipolar disorder, half of those with schizophrenia and a substantial portion of those with substance abuse disorders. GDs are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a supernatural, science-fictional, or religious theme.
Vampires with this derangement must determine a set of specific beliefs, as described above, and follow them accordingly. The effects of GD-induced behavior can be negated for the course of one scene by spending a temporary Willpower point. The difficulty of any attempt to coerce or Dominate a vampire into acting against her delusion is raised by one (at Storyteller's discretion). If a vampire is forcibly prevented from adhering to her belief, she automatically frenzies.