Is the struggle of this world merely a pleasant game for you?
Do you long for a more brutal take on a life lived post apocalypse?
If you answered "Yes and yes!", Survival difficulty is for you!”— Fallout 4 loading screen hints
Survival difficulty (sometimes called Survival mode) is a difficulty mode in Fallout 4 meant to make the game more challenging for experienced players. Survival can be selected at the start of a game or switched to from the pause menu at any time. Survival difficulty is the hardest difficulty of Fallout 4.
Survival difficulty is one above Very Hard difficulty. It can be switched to at the start of the game or at anytime the player wants during their playthrough. However, once deactivated on any save file, survival mode cannot be activated again for the rest of the game.
In an late April 2016 update, Survival difficulty was overhauled to be more similar to Hardcore mode from Fallout: New Vegas where the player will have to keep track of their Sleep, Hunger and Dehydration as well as watch out for diseases and other dangers of the Commonwealth. The table below summarizes these differences in more detail.
Before the update, Survival difficulty was very similar to Very Hard difficulty. Both difficulty settings halved the player's damage output and doubled the damage output of enemy NPCs when fighting the player. The only differences between Survival and Very Hard was that health restoration from all sources was reduced and Legendary creatures appeared more often. However, with the update, once one regresses to an easier difficulty, they cannot return to Survival difficulty again for the rest of the game.
|Can manually save or quick save whenever the player wants.||Manual and quick saves are disabled. Player can only save when sleeping for an hour or more, thus autosaving the game.|
|Standard combat.||Combat is more fast and lethal for all parties.|
|No Adrenaline perk.||Sole Survivor gains the Adrenaline perk to balance lethality of combat.|
|Player can fast travel.||Fast travel is disabled.|
|Enemies appear on the compass based on how perceptive you are.||Enemies no longer appear on the compass.|
|No dehydration. No starvation. No sleep deprivation.||The Sole Survivor must drink, eat, and have proper sleep cycles or will suffer increasing negative effects, such as SPECIAL penalties and physical damage, stacked with Fatigue and Sicknesses.|
|Stimpaks and food heal instantly.||Stimpaks and food heal over time.|
|Additional statistic bonuses from food are constant.||Additional statistic bonuses from food can only occur if properly fed.|
|RadAway heals radiation poisoning instantly.||RadAway heals radiation poisoning over time.|
|Radiation medicine can only help.||Radiation medicine lowers radiation, but also lowers one's immunity, causing them to become sick more easily, and increases fatigue by making one more tired.|
|No fatigue.||Fatigue affects the Sole Survivor by damaging their Action Points bar.|
|No sickness and diseases||The Sole Survivor needs to be mindful of what they put in their body. Drinking contaminated water, eating uncooked meat, taking chems, getting damaged by disease ridden creatures, and sleeping in dirty sleeping bags or mattresses can afflict the Sole Survivor with various diseases and illnesses.|
|No antibiotics||To combat sickness and diseases the Sole Survivor will need to use antibiotics, which are craftable or purchasable from various doctors.|
|Crippled limbs auto-heal after battle.||Crippled limbs no longer heal after battle but instead need to be treated by a Stimpak.|
|Stimpaks and Ammunition are weightless.||Stimpaks and Ammunition has weight, which is dependent on the ammunition's size.|
|Standard carry weight||Carry weight is significantly reduced for both the Sole Survivor and their companions.|
|Companions heal themselves after battle.||Companions need to be healed by the Sole Survivor, and will return home if they are left hurt.|
|Locations repopulate with loot and enemies normally.||Repopulation is reduced to a slower rate.|
- Fallout 4 loading screen hints: "Need a real challenge? Try Survival difficulty. Health restoration will be severely reduced."
- Fallout 4 loading screen hints: "In Survival, manual, quicksaving & most autosaves are disabled. To save your game, you'll need to find a bed and sleep for at least an hour."
- Fallout 4 loading screen hints: "In Survival, Adrenaline provides a bonus to your damage output. The higher your Adrenaline, the higher the damage bonus. Sleeping for any amount of time will lower your Adrenaline, taking your damage bonus down with it."
- Fallout 4 loading screen hints: "In Survival, Fast Travel is disabled. If you wish to be somewhere, you'll have to get there the old-fashioned way."
- Fallout 4 loading screen hints: "In Survival, enemies no longer appear on your compass. Keep your eyes peeled, and your weapon ready."
- Fallout 4 loading screen hints: "In Survival, you'll find it difficult to survive without taking proper care of yourself. Going for extended periods of time without food, water, or rest will begin to adversely affect your health. Stay hydrated, fed, and rested to remain combat-ready."
- Fallout 4 loading screen hints: "In Survival, going without food, water of rest will begin to adversely affect your health, hurting your SPECIAL stats, adding to your Fatigue, lowering your immunity, and eventually even dealing physical damage to you."
- Fallout 4 loading screen hints: "In Survival, a food's bonus effects, such as increased carry weight from Radstag steak, will only apply if eaten when you are not currently hungry. Make sure to take care of the basics before eating for bonuses."
- Fallout 4 loading screen hints: "In Survival, items that cleanse your body of Rads come with the cost of making you tired and temporarily damaging your immunity, leaving you more vulnerable to Illness than usual."
- Fallout 4 loading screen hints: "In Survival, Fatigue works like radiation, but affects your Action Points (AP) rather than your Hit Points (HP). Fatigue mostly comes from being tired, but both hunger and thirst also affect it. The more Fatigue you've built up, the less AP you'll have for actions like sprinting and VATS."
- Fallout 4 loading screen hints: "In Survival, eating uncooked meat, drinking unpurified water, taking damage from disease-ridden foes and using harmful Chems all put your body at increased risk for various ill effects. Be smart and keep Antibiotics handy."
- Fallout 4 loading screen hints: "In Survival, Antibiotics, which can be crafted at Chem Stations, purchased from doctors or found in medical containers, instantly heal the various effects of Illness."
- Fallout 4 loading screen hints: "In Survival, Crippled limbs will no longer auto-heal after combat. You will remain crippled until you are healed from a Stimpak or until you sleep it off."
- Fallout 4 loading screen hints: "In Survival, Stimpaks and Ammo both have weight. Bullets and shells 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."
- Fallout 4 loading screen hints: "In Survival, both you and your companion's Carry Weight has been significantly reduced. Exceeding your carry weight reduces your Endurance and Agility stats, and periodically damages your legs and health. Think of your back!"
- Fallout 4 loading screen hints: "In Survival, if your companion goes down during combat, you must heal them before they can get back up. If you leave the area without healing them, they will return home to recover."