Derangements are behaviors that are created when the mind is forced to confront intolerable or conflicting feelings, such as overwhelming terror or profound guilt. When the mind is faced with impressions or emotions that it cannot reconcile, it attempts to ease the inner conflict by stimulating behavior such as megalomania, bulimia or hysteria to provide an outlet for the tension and stress that the conflict generates.​

Characters receive derangements under conditions of intense terror, guilt or anxiety. Other examples of derangement-inducing events include killing a loved one while in a frenzy, being buried alive, or seeing hundreds of years of careful scheming dashed in an intense and unpleasant emotion or thoroughly violates a character's beliefs or ethics is severe enough to cause a derangement.​

It must be noted that people who are "crazy" are neither funny nor arbitrary in their actions. Insanity is frightening to those who are watching someone rage against unseen presences or hoard rotten meat to feed the monsters that live next door; even something as harmless-sounding as talking to an invisible rabbit can become disturbing to onlookers. The insane, however, are only responding to a pattern known to them, stimuli that they perceive in their own minds. To their skewed perceptions, what's happening to them is perfectly normal — to them. Your character's derangement is there for a reason, whether he's a Malkavian who resided at Bedlam before his Embrace or a Ventrue who escaped from five months of torture at the hands of an Inquisitor. What stimuli is his insanity inflicting on him, and how is he reacting to what's happening? The player should work with his Storyteller to create a pattern of provocations for his derangement, and then decide how his character reacts to such provocation.​

Derangements are a challenge to role-play, without question, but a little time and care can result in an experience that is dramatic for all involved.​



Antisocial: Antisocial Disorders reflect a lack of compassion, empathy and consciousness. Antisocial characters tend to place their own needs above those of others every time.

Avoidant: Avoidant Disorders reflect social anxiety. These characters often fear rejection and feel inadequate, and cope with this by sticking to routine and avoiding any new situations. Most Avoidant people yearn for social relations, yet feel unable to obtain them.​

Borderline: Borderline Disorders reflect emotional instability. Borderline characters suffer heavy mood swings, sometimes taking their anger out on themselves. Their relationships with others tend to be intense and conflict-ridden.​

Dependent: Dependent Disorders reflect extreme fear of being alone. Needy and helpless, these characters cling to others, even through abuse, fearing rejection more than anything else. Typically, they let other do the decision-making for them.​

Histrionic: Histrionic Disorders reflect the need for attention. Histrionic characters can't stand being ignored and seek to be center of attention in every situation. They inflate social relations, over exaggerate injuries and seek constant praise above everything else.​

Narcissistic: Narcissistic Disorders reflect self-centeredness. Narcissistic Characters believe that everything revolves around them, seeking to acknowledged as superior and often disregard the feelings of others.​

Obsessive-Compulsive: Obsessive-Compulsive Disorders reflect focus on perfection. Obsessive persons can't stand the thought of making a mistake, and often set unreasonably high standards for everyone. They have difficulty expressing emotion and focusing overly on order and preciseness.​

Paranoid: Paranoid Disorders reflect extreme distrust. Paranoid figures believe that others have sinister hidden motives and relentlessly search for them. Usually, they shift blame from themselves to others maliciousness and have long grudges.​

Schizoid: Schizoid Disorders reflect dislike of company. Schizoid characters prefer to be left alone, rejecting the need for social acceptance or attention. In contrast to Avoidant persons, Schizoid persons truly prefer this state of things.​

Schizotypical: Schizotypical Disorders reflect odd forms of thinking outside the norm. Their speech patterns are convoluted (although still understandable), and they have difficulties concentrating for long periods of time.​



Agoraphobia: Characters with Agoraphobia have an extreme aversion to open spaces or places from which escape is not easily possible. Sometimes, Agoraphobia is tied to places where the character fears he will panic.

Amnesia: Characters with Amnesia lose recollections that feel traumatic, unsafe, or unreal. Amnesiacs might block out parts of their identity, forget certain people or places, blank out specific incidents, or function in a level of reality where the forgotten thing (a brother, a home, a missing arm) simply does not exist.

Antisocial Personality Disorder (ASPD): Also known as sociopathy or psychopathy, persons with this affliction cannot comprehend the feelings of other people or understand the impact of her actions on the emotional lives of anyone outside themselves. Feeling no remorse or objections against activities like lying, cheating or stealing, persons with ASPD can appear charming as long as you do not stand in their way.

Berserk: Characters with Berserk tend to have difficulties controlling feelings like anger or frustration. When confronted with stressful situations, the character will likely lash out against them in a blind rage.

Bipolar Affective Disorder (BAD): Also commonly known as manic depression, bipolar characters experience immense mood shifts. Manic states tend to spark impulsive behavior, unrealistic expectations, and intense passions; depression saps energy, crushes self-esteem, and grinds motivation and confidence into black paste.

Bulimia: Characters with Bulimia cope with stress by indulging in activities that comfort them, in most cases feeding. 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.

Compulsion: Characters with Compulsion might seem similar to persons with OCD, but their need is much more visceral. Compulsed characters feel an overwhelming need to do a specific physical action when confronted with a specific action.

Dependent Personality Disorder (DPD): Characters with DPD are extremely indecisive, preferring that others make their decisions for them. Most of this springs from fear of abandonment, and the more the character depends on others, the more he will feel inadequate to face his issues alone.

Fugue: Also known as disassociative amnesia, a character with Fugue will periodically disassociate herself from her identity and relationships, sometimes forgetting who she is/was until she returns from that fugue state.

Histrionics: Characters with Histrionics seek the spotlight in even the most inappropriate situations. They affect extreme but shallow emotions or behave and dress provocatively. Histrionics are hypersensitive to the opinions of others, not oblivious to the glares of the crowd as they enact some slapstick melodrama.

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.

Klazomania: A person suffering from Klazomania can and will not lower their voice, constantly shouting at the top of their lungs.[15] Megalomania: Also known as narcissistic personality disorder (NPD), persons with Megalomania believe themselves superior to everyone around them. Grand delusions, power fantasies, intense feelings of superiority, and an inflated sense of self-esteem are all common marks of Megalomaniacs.

Memory Lapses: Unlike Amnesia or Fugue, the character simply "forgets" small tidbits of knowledge, often at inopportune times. This can range from something as simple as forgetting the location of a small object, to forgetting an entire Skill or Knowledge.

Multiple-Personality Disorder (MPD): Sometimes also known as disassociative identity disorder, persons with MPD develop consciously and/or subconsciously several other identities for themselves. 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.

Obsessive-Compulsive Disorder (OCD): Also sometimes referred to as Monomania, persons with OCD focus nearly all of their attention and energy on a single repetitive behavior or action. Essentially, a person with OCD fixates on intrusive doubts and fears: Fixations she tries to banish by making sure that certain things are in order, even if they already are.

Overcompensation: Persons who overcompensate make sure that every of their actions is outstanding, trying to hide a hidden failure of character of simply having low self-esteem. They never undertakes anything half-heartedly; nothing is worth doing for its own sake.

Paranoia: Persons with Paranoia believe that someone external is responsible for all their misery. Paranoid individuals obsess about their persecution complexes, often creating vast and intricate conspiracy theories to explain who is tormenting them and why. A paranoid person sees plots and rivals everywhere, even among his friends. Trust becomes foolishness because no one can be trusted.

Phobia: Characters that suffer from Phobia harbor irrational, debilitating fears. A phobia may take any form, from a simple fear of spiders, to fear of a particular popular figure, to a fear of automobiles, to a crippling fear of vampires.

Power-Object Fixation: Characters with a Power-Object Fixation believe that their skill and self-confidence is bound to a specific object (that has no such properties). The character cannot function properly without this object around him.

Post-Traumatic Stress Disorder (PTSD): PTSD arises in response to severe trauma such as combat or rape. Symptoms manifest as recurrent, debilitating flashbacks and extreme avoidance of situations likely to recreate the initial trauma.

Regression: Characters that suffer from Regression tend to revert back to a childlike state in stressful situations. In such a state, the character rarely thinks of himself as a child, but instead exhibits poor sense for cause and effect, fear of the unknown, a tendency to avoid confrontation and reliance on a strong "parent" figure.

Schizophrenia: Characters that suffer from Schizophrenia usually exhibit withdrawal from reality, violent changes in behavior, and hallucinations. All of this are reflections of an internal trauma that the character cannot resolve. The cause of this conflict varies from individual to individual.

Self-Defeating Personality Disorder (SDPD): Also known as Masochism, characters that suffer from SDPD tend to associate a feeling of pain and/or other feelings of discomfort. Many fear to assert themselves against the sources of their pain, others do not know anything different, and others rationalize it as punishment for their "sins".

Sexual Dysfunction: Sexual Dysfunctions are an umbrella term for several ailments, like vaginism, dyspareunia or impotence. All such conditions are likely to instill an extreme aversion to sex.

Synesthesia: Character with Synesthesia experience a scrambled sensory input. He "tastes" colors, "sees" smells and similar shifts in perceptions. While most victims of Synesthesia grow accustomed to it, challenges can arise when they have to communicate such information to others.


While the following derangements are most often the result of an abuse or overly strong focus on a specific Discipline, others might experience similar derangements.​

Animal Personification: Commonly associated with Animalism, the vampire comes to treat animals like humans, believing that they can understand him and expecting them to answer.​

Blood Fetishism: Commonly associated with Quietus, the vampire suffers an unhealthy fascination with blood. They cut themselves just to see the blood flow, feed slowly to savor the taste and perform other disturbing acts.​

Compulsive Invisibility: Commonly associated with Obfuscate, the vampire has been so attuned to invisibility that it costs Willpower for him to turn his powers off.​

Disdain of Weakness: Commonly associated with Potence, the vampire will always use full force when interacting with objects and comment on the fragility and weakness of their surroundings.​

Disorientation: Commonly associated with Celerity, the vampire finds the way things move in normal speed disorienting, insisting that they should move slower.​

Disregard of Human Form: Commonly associated with Serpentis, the vampire finds himself more comfortable in another form than the one resembling his mortal days. If suggested that they transform back, they have to check Frenzy.​

Empathic Blindness: Commonly associated with Dominate, the vampire cannot understand why anyone wouldn't heed his commands or else disagree with him, similar to sociopathy.​

Illusion Addiction: Commonly associated with Chimerstry, the vampire becomes so enamored with his own creations that they completely lose sight of the real world, instead surrounding themselves with pleasurable illusions.​

Lack of Survival Instincts: Commonly associated with Fortitude, the vampire comes to believe that he is actually indestructible, willingly facing mortal danger.​

Thaumaturgical Glossolalia: Commonly associated with Thaumaturgy (although in theory, any school of Blood Magic could be the catalyst), the vampire falls into speaking and thinking only in terms of magical correspondences and symbology. Similar to magical aphasia, the vampire cannot communicate this state of mind to others and eventually fails to recognize anything other than these correspondences.​

Unconscious Influence: Commonly associated with Presence, the vampire activates his persuading powers without acknowledging that he use them. If someone would point the use out to them, they vehemently deny it.​

Unconscious Thought Reading: Commonly associated with Auspex, the vampire begins to casually invade the mind of others, reacting to thoughts before they are spoken. Too many people cause a static background noise that can drive the vampire into Frenzy.​


While most supernatural derangements are only found among a specific demographic of supernaturals, some might be adapted to affect other beings with similar powers (i.e a mage might have a derangement similar to Disassociative Blood-Spending, only with Quintessence instead of vitae).​

Acute Sanguinary Aversion: A derangement only found among vampires, its victims believe that vitae is dangerous, cursed or otherwise evil. Such vampires refuse to come in contact with blood until they eventually fall into Frenzy, gorge themselves and have likely even more disgust of vitae than before. Some cope with long ceremonies meant to "cleanse" the blood before they ingest it.​

Blood Sweats: The character has a tendency to "sweat out" vitae. Many other vampires find this particularly disturbing, as the sweat stains clothes and make the vampire in question a horrid sight to look upon. Such figures are also obvious breaches of the Masquerade.​

Hierarchical Sociology Disorder (HID): Most commonly found among Clans with demanding structures, such individuals let themselves fall into the hierarchy to absolve him of the realities of his nightly existence. Such individuals behave almost drone-like, ignoring their slow degeneration and fall to the Beast by asserting that this is neither their fault nor their problem.​

Desensitization: Commonly found among vampires, the character has lost every feeling in his dead body. This affects his ability to feel any emotion except in highly rationalized forms or through foreign influences like the Blood Bond or Dominate. Such desensitization makes it difficult to truly devote oneself to Humanity or a Path of Enlightenment.​

Dissoziate Blood-Spending (DBS): The vampire spends blood often unconsciously, to augment his attributes in inappropriate times or even during the day, leaving him often hungrier than other vampires.​

Dissociate Perceptions Syndrome (DPS): Appearing after the Week of Nightmares to affect users of Chimerstry, such individuals find that they are unable to distinguish between their summoned illusions and personal hallucinations.​

Sanguinary Animism: Vampires that suffer from Sanguinary Animism believe that they consume the souls of their victims along with their blood. 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.​

Sanguinary Cryptophagy: Vampires that suffer from this derangement tend to disregard the taste of normal vitae in exchange for more exclusive tastes. Some become addicted to Lupine blood, while others find themselves drawn to diablerie members of specific Clans or bloodlines. While the vampire can still consume regular blood, he will refuse to do so unless in Frenzy.​

Self-Annihilation Impulse (SAI): Commonly found among Elders, the vampire has the unconscious desire to experience Final Death. When such individuals are confronted with their own immortality, they head off for a possibly life-threatening situation, like breaching the Masquerade or challenging their superior to Monocacy.​

Severe Dysmenorrheic Psychosis (SDP): SDP is a derangement among female ghouls. They tend to suffer from severe cramps, paranoid delusions, and depression during their menstrual cycle. If they expulse parts of their vampiric vitae, the victim suffers from panic attacks and fears to die. There is no cure yet, although the Malkavian Dr. Douglas Netchurch has developed a serum that can alleviate the symptoms.​
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