Mental Stability System - New Vegas (In)sanity Mod
🟠 Updated over a year ago⚠️ Install Order · 5 steps
Install in this order, then this mod last — most mods fail to load without their framework and dependencies in place.
Preview

🔍 Analysis
- 👍 0.3% endorsement rate
- 🏆 #144 of 441 Gameplay Effects and Changes mods in this game by downloads
📋 About This Mod
Mental Stability System is a relatively complex mod that introduces a Sanity mechanic into the game. Various in-game events and factors will affect the player's sanity, both positively and negatively. Once your sanity wrosens beyond a certain threshold, you will start hearing voices and even experience hallucinations. The voices will sometimes talk nonsense, but other times they will be directly talking to you or reacting to your actions and other things happening in game. The worse your sanity gets, the more intense, aggressive and frequent the voices become. That's the basic idea, anyway. But if you want to know more, keep reading this description. There's also a thorough guide talking about pretty much every feature of this mod in the Articles section. It's not necessary to read it to understand the Mental Stability System, because I'd say pretty much everything in this mod is intuitive, but it's still usefull if you want to know the details of how the system works.
TTW VERSION HERE
F3 VERSION HERE
[]The Voices - As mentioned above, you will start hearing voices when your sanity gets bad enough. There are basically 3 main voices that you will be hearing (with some others chiming in here and there) with over 300 unique voice lines. And all of them are voiced by real voice actors that I hired specifically for this mod, no AI was used.
[]Sounds - Alongside the voices, you will also sometimes be hearing various creepy sound effects. There are almost 100 unqiue sound effects in total.
[]Visual Hallucinations - With the 2. 0 update came various visual hallucinations, but revealing their specific nature here would kinda spoil the experience. If you find out they're not your cup of tea, you can turn them off in the config file.
[]Cyberpsychosis - Introduced in version 3. 0, this feature makes it so cybernetic implants affect your sanity. If you have too many of them, you can start experiencing cyberpsychosis during combat (inspired by Edgerunner perk from Cyberpunk 2077).
[]Antipsychotics - This mod also introduces a new aid item called Antipsychotics. As the name suggests, it is there to help you manage your degrading sanity and keep the voices silent. They come with scripted LL integration and are craftable.
[]Self-contained - Basically the entire mod is self-contained. By that I mean almost no vanilla records were touched and it should be compatible with pretty much anything. (There are some minor caveats though, so check out COMPATIBILITY near the bottom of the page.)
[*]DLC included - The mod was made with all DLCs in mind, so the voices will also be reacting to events in all four main
Adds a complex sanity system to Fallout: New Vegas that dynamically reacts to in-game events. With 676 endorsements and 264,595 downloads, it's a popular gameplay overhaul for players seeking a deeper, more psychological challenge.
✨ Key Features
📊 Pros & Cons
✅ Pros
- Huge download count (264k) shows tons of players are trying it out.
- 676 endorsements means the community digs it enough to back it.
- Adds a fresh layer of challenge for veterans who know the Mojave inside out.
⚠️ Cons
- Last updated in January 2025, so it might not be fully compatible with the latest game patches or mods.
For Fallout: New Vegas players who want a fresh twist on survival and role-playing, especially those who've exhausted the vanilla game. If you're a completionist looking for new challenges or a roleplayer who enjoys psychological depth, this is for you. Skip if you prefer straightforward gameplay without extra mechanics to manage.
💡 Beginner Tips
- Check the mod's forum or comments section for user-install guides, since the description lacks details.
- Make sure you have the latest New Vegas Script Extender (NVSE) installed, as most gameplay mods require it.
- Start a new playthrough to experience the sanity system from the beginning, as mid-game saves might not trigger properly.
📊 Mod Details
- Game
- New Vegas Mods
- Author
- ProfMajkowski
- Version
- 3.1.2
- Downloads
- 264,595
- Endorsements
- 676
- Category
- Gameplay Effects and Changes
- Created
- 5/26/2024
- Updated
- 1/22/2025
🔧 How to Install New Vegas Mods
Download from Nexus.
📖 Full step-by-step install guide for New Vegas →
Visit the official mod page for specific installation instructions for this mod.
🎮 Need cheat codes or console commands? Check ur gaming wiki for New Vegas commands, item IDs, and more.
Keep browsing — more New Vegas mods await