A PC or NPC exposed to extreme physical exertion such as a lack of sleep, starvation, exposure to heat or cold, disease, or blood loss can suffer Exhaustion. Exhaustion can also be the effect of attacks by certain creatures. Checks to oppose gaining Exhaustion are made against CON.

A PC or NPC exposed to extreme mental exertion, soul-shivering horror, torture or bearing witness to unspeakable acts or sights can potentially suffer Stress. Some environmental effects can inflict Stress, such as surviving a particularly nasty battle, or spending several days without food. Stress can also be an effect of attacks from certain creatures. Checks to oppose gaining Stress are made against WIS.

As PCs and NPCs gain stress and exhaustion they weaken. Each is measured in six levels. An effect can give a creature one or more levels of exhaustion or stress, as specified in the effect’s description. Unless there are other circumstances preventing it, PCs and NPCs can choose to cure one level of exhaustion or one level of stress for each safe rest.

1. Disadvantage on any STR, DEX, or CON skill checks
2. Speed halved
3. Disadvantage on attack rolls
4. Hit point maximum halved
5. Speed reduced to 0
6. Death

1. Disadvantage on any INT, WIS, or CHA skill checks
2. Gain one of the following conditions until stress is reduced to 0 (roll randomly):
   • Demoralized
   • Distracted
   • Haunted
   • Pained
3. Disadvantage on magic checks and attacks
4. Sleep does not heal exhaustion (nightmares)
5. Temporary insanity (The player experiences hallucinations, hears voices in their head, experience powerful urges to do things they normally wouldn't, and other mind-altering events)
6. Permanent insanity and debilitation

Stress and exhaustion of NPC retainers will be handled differently for simplicity's sake. Instead of noting the levels and effects above, players just to assign a level of the Drained condition on them, essentially lowering all checks, attacks, and morale by one for each level suffered. The effects of being drained both through exhaustion and stress are cumulative, and once they reach 6+ the NPC either dies of exhaustion or falls into a permanent catatonic state.