Illness, Adrenaline In Fallout 4’s Survival Overhaul

Fallout 4 is best enjoyed as a survival game,” our Alec said as Michael Radiatin’ set out to explore the post-apocalypse in his charminly inept but enthusiastic way. The ‘Survival’ difficulty level of Fallout 4 [official site] isn’t much of a survival game, though. So Bethesda are busy revisiting and overhauling it, and now we have a peek at their plans. Expect diseases from dirty monsters, no manual saving, fatigue and adrenaline levels to manage, and plenty more dangers and delights.

A chap rummaging in data fils dug up a description of Survival mode and yup, Bethesda have confirmed it’s real. They do say this is only an “early look” at the new Survival, though. “We’re still messing [with] it,” they add. “More to come!”

But here are the lines they’re thinking along, and what’s presumably coming to a beta update near you soon:

Manual and quicksaving are disabled. To save your game, you’ll need to find a bed and sleep for at least an hour.

Combat is more lethal for everyone. You now deal, but also take, more damage. You can increase the damage you deal even further with “Adrenaline” (see below).

Fast Travel
Fast Travel is disabled. If you wish to be somewhere, you’ll have to physically travel there.

Weighted Ammo
Bullets and shells now all have a small amount of weight, which varies by caliber. Heavier items such as fusion cores, rockets, and mini-nukes can really drag you down.

Be sure to keep your eyes peeled, as enemies will no longer appear on your compass. As well, the distance at which locations of interest will appear has been significantly shortened.

Survival automatically grants the Adrenaline perk, which provides a bonus to your damage output. Unlike other perks, the only way to increase your rank of the Adrenaline perk is by getting kills (hostile or otherwise). The higher your Adrenaline rank, the higher the damage bonus. Sleeping for more than an hour, however, will cause your Adrenaline rank to lower. You can check your current Adrenaline rank at any time in the Perks section on the Stat tab in your Pip-Boy.

You’ll find it difficult to survive without taking proper care of yourself. You must stay hydrated, fed, and rested to remain combat-ready. Going for extended periods of time without food, water, or sleep will begin to adversely affect your health, hurting your SPECIAL stats, adding to your Fatigue (see “Fatigue” below), lowering your immunity (see “Sickness” below), and eventually even dealing physical damage to you.

Fatigue works like radiation but affects your Action Points (AP) rather than your Hit Points (HP). The more Fatigue you’ve built up, the less AP you’ll have for other actions. The amount of Fatigue you’ve accumulated is displayed in red on your AP bar.

A comprised immune system and a few questionable decisions can end up getting you killed. Eating uncooked meat, drinking unpurified water, taking damage from disease-ridden sources, such as ghouls and bugs, or using harmful Chems all put your body at increased risk for various ill effects. When you are afflicted with an illness, a message will appear onscreen. You can view specifics about your current illnesses by navigating to the Status section on your Pip-Boy’s Data tab and pressing [RShoulder] to view your active effects.

Antibiotics, which can be crafted at Chem Stations or purchased from doctors, heal the various effects of sickness.

Bed Types
The type of bed you’re sleeping in determines the length of time you are able to stay asleep. A sleeping bag will save your game and may help save your life when you’re desperate, but it will never allow for a full night’s rest and the benefits that come with it.

Crippled Limbs
Crippled limbs will no longer auto-heal after combat and will remain crippled until healed by a Stimpak.

Carry Weight
Exceeding your carry weight reduces your Endurance and Agility stats and periodically damages your legs and health. Think of your back!

Companions will no longer automatically get back up if downed during combat and will return home if abandoned without being healed.

Enemy and Loot Repopulation
Locations you’ve cleared will now repopulate enemies and loot at a significantly slower rate.

Heck, that’s more survival gamebits than you’ll find in many Early Access release sold explicitly as survival games.


  1. Premium User Badge

    Lexx87 says:

    This sounds like the game i’ve been waiting for. I’m happy to have held off playinf until now!

    I’m really waiting for the mod tools to come out mind, I only have time to play this once so i’ll wait for a good time…

  2. pfooti says:

    Very excited about this new feature. I played a fair bit of FO4, but kind of got pooped out with it. I’d love to restart from scratch with a stronger survival mode for sure.

  3. Michael Fogg says:

    Yep, can’t wait to try this out. Still, I think a crippled limb should be healed by a visit to a doctor or autodoc, not via a stimpack. This mode won’t change the fundamentally repetitive nature of FO4, but at least make it more engaging, maybe.

  4. DuncUK says:

    This sounds like a good idea, but the game engine and general wonkyness of FO4 would put me off any sort of limited save system. I died hundreds of times for all sorts of bullshit reasons during my playthrough, including the physics engine freaking out and fatally hurling inanimate objects at me. I just can’t see the endless, inevitable backtracking upon death being at all that fun.

  5. aepervius says:

    This sound great for everything except *one* detail : no manual saving. I have been hit way too many time by crash to desktop or problems with Fallout games that such option makes me wince & balk at the idea. I would like to see at the very least automated save… When you enter the new areas for example (that is where in the past I experienced the most crash . during transitions).

  6. Moonracer says:

    This certainly sounds like a step in the right direction. And of course it will be the foundation for even better survival mods.

    I agree taking away save-game control is iffy, but I’m sure someone will make something like the FONV place-able bedroll.

  7. Premium User Badge

    phuzz says:

    The best thing about survival mods for games is that I don’t have to install them, and thereby keep my games fun, rather than a slightly more radioactive version of real life.
    Wait, this isn’t a mod is it :(

  8. Blackcompany says:

    If only some method existed for creating a survival game that didn’t devolve into status bars and inventory management. This might make the game more challenging, but how much of that challenge will come from tedium versus engaging game play?

  9. Barberetti says:

    “Manual and quicksaving are disabled”

    Fuck that.

    • Harlander says:

      Yeah, I’d be pretty interested but disabling saves is a dealbreaker.

    • Eddy9000 says:

      I think there’s a clue in the reference to a ‘sleeping bag’ which only saves your game and doesn’t give the benefits of a bed. Likely you’ll be able to sleep-save anywhere out of combat.

      • jonfitt says:

        Sleeping bags are an existing static bed type in the game, they’re found all over. It’s not clear if they will be adding a carryable sleeping bag, although this would make a lot of sense.

        That way you could save at will, you’d just have to find a quiet corner for a kip.

  10. Mr_Blastman says:

    This is the Fallout 4 we’ve been waiting for

  11. Premium User Badge

    Iamblichos says:

    I hope they give a way to disable the intro scenes pre-starter area. Wasting that 10-15 mins every time you want to roll up a new character knowing that s/he will most likely die soon will be a dealbreaker after a very short time.

    • jonfitt says:

      I guess you could clear the initial vault, then save in a bed before you leave and get the option to edit your character.

  12. Mittens89 says:

    Time to stop playing, wait for this to come out, and then start again. Properly.

    Might as well grab that season pass for now. As much as I dislike season passes, I think Bethesda make some pretty good DLC so £20-£25 doesn’t seem too bad.

  13. Mezmorki says:

    Well … as the lead mod author behind Fallout 3 Wanderers Edition, this is really cool to see the official game having a version that takes it in basically the same direction. That list of changes looks shockingly similar to FWE’s changelog:
    link to

    • rexx.sabotage says:

      Bethesda are certainly keen to recognize good ideas, they would rather not have to pay someone for them, however.

      Thanks modding community.

  14. neofit says:

    I agree that Survival Mode is a joke. When you play from level 4ish to the end on Survival, and end up with hundreds of stimpacks and radaways and throw away food, something is not properly balanced. So I agree with everything that makes health management harder. But don’t you touch the save-anywhere feature. Total deal-breaker. Make it optional.

    • snowgim says:

      Yes, I’m very worried about this, especially since I’m halfway through playing on Survival. Is this update going to wreck my game?
      I like most of the changes, and I’m very happy about it getting harder, but harder shouldn’t mean I have to replay the last hour because I couldn’t find a bed. :(

    • hyru99 says:

      I agree the no manual save is crap. I mean I may be willing to accept autosaves such as what Call of Duty has or has as well. But if the auto save is to far apart it just isn’t worth the risk of crashes or deaths. I always play games as hard as possible, but these types of games shouldn’t limit saves.

  15. oyog says:

    I think I’ll stick with NEO Scavenger for hardcore survival. I like Fallout 4 for what it is. Mindless shooty RPG-lite fluff.

  16. silentdan says:

    Still going to wait for the GOTY ($80 for the base game here in Canada, and that’s just too steep) but this is good news. I’m a big fan of the series.

  17. JarinArenos says:

    This is everything I wanted and more.

  18. Stevostin says:

    Ok, I am hot.

  19. celticdr says:

    Now all we need is a vehicle to get around… horses? No, too Oblivion… vertibird? If you’re going to join the Brotherhood fine but what about the rest of the factions? Motorcycle? Hell. Yeah.

    • epeternally says:

      The map isn’t exactly big. I constantly find myself completely on the opposite side without even meaning to, just by doing a bit of wandering. A vehicle would only further highlight the map’s deficiencies. Though with there being working robots and generators (built from scratch!), the fact that someone can’t get a motorcycle or ATV running seems a little ridiculous. But then, every other aspect of the world building lacks consistency as well so I guess that’s just par for the course.

  20. racccoon says:

    I finally crapped on the institute with the minutemen, I really didn’t need their help, they get in the friggin way! but anyway! I think its time to blow the airship Brotherhood of Steel destroyed, once I’ve done that + all their quests..I’m onto the minutemen, but, unsure whether I can actually pull off killing the minutemen as they hold most of rep with the settlements n such I’m currently level 63..what a great game this is..

  21. machineageproductions says:

    This has two huge negatives for me:

    1) It sorely discourages using Sanctuary Hills as a home base. Going there from pretty much any of the important spots on the map would be annoying without fast travel.

    2) I don’t think the game has sufficient feedback to support play without the compass ticks in combat. I know without them, I’d just be tapping the VATS button, which only serves to make gameplay more annoying, not more fun.

    I do like that they’re removing the completely annoying and un-fun bullet sponge mechanics of the current survival mode. A heavily modified rifle with a sneak attack headshot is barely enough to scratch a lot of the things you deal with in that mode.

    I sorely hope they allow for a portable bed roll. I get not allowing frequent convenience saves. But I’m not going to trek all across the wastes for a quest, only to do it again if I stumble on a raider with a mini-nuke.

    • Antongranis says:

      I think its good that The disable fast-travel, as i think it is The very best way to play and bethesda-game. I think You might take to it! The lack off manual saving is going to be frustrating in case of craches however.

      I think it would be best if all These things were individually togggles.

    • fish99 says:

      At least if you don’t use SH as a base you won’t get hassled by Preston every two seconds.

  22. Rince says:

    Ok. Sounds nice. But I don’t like the lack of manual saves.

    • Akula says:

      Survival all the way. Need to move out ? Noooope, get a bed first

  23. Akula says:

    I love how the news come 1/2 days after all the others here

  24. Peppergomez says:

    If the graphics in this game look as bad as those in the screenshot in this article, I don’t think I’ll ever buy this game. It looks about as good as dog food.

    • Zimy111 says:

      you can be assured with the HBAO+ and a decent computer this game will not disappoint.. ;)

    • Zimy111 says:

      I do agree with you though the deca/octagon ash tray does not look very appealing in this screen shot haha

    • fish99 says:

      The game looks decent overall. Don’t judge the visuals by that screenshot.

  25. Zimy111 says:

    I have been waiting for this to happen since fallout 4 was released!!

  26. fish99 says:

    I want to play F4 again at some point in the future but focus on just exploring the map, finding all the stuff I missed in my playthrough, and avoid as much of the boring story, factions and radiant quests as possible.

    Sounds like this mode would make that worth doing.

  27. hyru99 says:

    Man finally they bring something I would have searched for a mod for and they add save game limitations? Do Bethesda know how often the game crashes and such. OH well blame it on mods? Firstly if Fallout or Elder Scrolls didn’t have mods, they would probably be half as appealing to me.

    I seriously hope you can toggle off the limit saves or someone finds a work around. I loved the idea of “real life” difficulties with this, but the saves is just going to make it unbearable.

  28. ShadowBoyTR says:


  29. Ke says:

    Better have the sleep bag as an item, sleep wherever u want, but whlie u sleeping the enemys can attack u in anytime then will wake u up, player can set up some mines and traps for defence before sleep, otherwise I really cant understand why we have mines and traps in game.

  30. ZaCookieMonsta says:

    This all seems like a really fun and adventurous update to the game, and I have some advice that might be worth listening to. I’ve never played survival games, but when you put fallout 4 into the mix I’m an instant fan.
    I will say one thing though, with the whole no fast traveling business, I really don’t see how we’re going to be able to stay on top of settlements, and make sure new recruits get to work as fast as possible (rather than just dragging down resources). If possible, you guys should add a feature to the game that gives new settlers a job as soon as they arrive. Maybe we could assign someone with high charisma to be the leader of each settlement? They could be the ones to assign jobs to new recruits (based on their skills), and maybe even send out radio signals if resources start running low.
    I don’t know if you will contribute this to your new update, or if anybody is even going to see this. But I do know that adding settlement leaders would add a whole knew layer to the survival mode, and the over all game in general. I hope you think about this, have a great day!