What exactly changes within a game when you increase the difficulty? The enemies have more health, the protagonist has less health and takes more damage, the boss fights take longer to complete. But some games take the concept even further, adding a new layer of fear to the gameplay and mechanics. So, without further ado, let's count down the 5 Horror Games with Hard Modes That Add to the Terror...

5. Outlast - Insane Mode

What's more horrifying than having to constantly escape prisoners in a corrupt asylum? Having to do it without dying. For the ENTIRE GAME. Outlast is a game that doesn't even have combat, so it heavily depends on stealth and hiding from enemies.

Such a handicap on the game is sure to make your experience even more terrifying because there's no room for mistakes. In order to complete such a mode, you will have had to memorize where every enemy is going to be and know where there's a place to hide at a moment's notice. Miles, did you really need this footage?

4. Fallout: New Vegas - Hardcore Mode

Yes, technically, this counts as an RPG, but I would classify the post-apocalyptic, dystopian theme of the Fallout franchise as horror. After all, what's more frightening than braving the elements of a savaged wasteland, having to fight mutated creatures just to stay alive, and encountering the very base desires of depraved humanity? Well, Fallout: New Vegas certainly answered the call.

You know it's going to be rough when the actual game is recommending you don't play Hardcore Mode. Your character is made substantially more fragile and adds negative effects based on a more realistic portrayal of survival in the wilds. There's a risk of starvation, lethargy, illness, and dehydration added to the already brutal decreases to the combat system. So if you are particularly masochistic, be sure to check out Hardcore Mode. Or you know... keep your sanity.

3. Resident Evil 7 Biohazard - Madhouse Difficulty

The game that no one expected to be good astounded us all by being the strongest entry in the Resident Evil series since the 4th installment. To those that complained of RE6 being too easy (or just too awful) will certainly see Madhouse Difficulty as a breath of fresh air.

The main differences in this mode are not just limited to the amount of damage enemies can take, but it also adds enemies to where there were none on a previous difficulty. The process of solving puzzles is also changes throughout gameplay, requiring more steps to solve the higher the difficulty is. And the bosses are now ridiculously beefy, meaning that you need to conserve your bigger guns, shells, rounds, and bullets for those encounters. If that sounds like your viscous cup of tea, then have at it.

2. The Evil Within - AKUMU Mode

You know it's going to be a doozy when the hardest difficulty has a Japanese name. Well, The Evil Within certainly delivers with AKUMU mode... a mode where even one enemy attack is instant death. The creatures are bulkier, more numerous, and even have more sensitive hearing, making sneaking much more of a pain in the neck.

The creatures' routing patterns are even different on this mode, meaning that you have to figure out a whole new sneaking method or get crafty with matches and various stabbing implements. If that's not already nerve-wracking, the bigger enemies are faster and take much more damage, so the fights are extra heart-wrenching when you're trying your hardest not to get hit by a stray tentacle/fist/whatever-that-fleshy-thing-is. If you really hate your thumbs, this is the game mode for you.

1. Silent Hill 2/Silent Hill 3

Yes, it's a tie. Because such games were so masterfully written and designed, that it's hard modes were infamous. Not only did they have combat difficulty, it also had puzzle difficulty. Who can forget Silent Hill 3's Hard Mode Shakespeare puzzle?

But its very own game mechanics were manipulated to make them not only painstakingly difficult, but also troll the gamer a bit. Like the Pyramid Head chase toward the end of the hospital level in Silent Hill 2. On normal mode, James would only have to run down the maze-like hallway leading toward the elevator, but on Hard Mode, James has to shoot Pyramid Head at every turn to slow him down enough to quit stabbing Maria and allowing him to get to the elevator.

Not only the game mechanics were changed, but the environment drained your health. In Silent Hill 3 on Hard Mode, during the sewer levels, the walls will turn a reddish fleshy color and the longer you stayed there, your health would deplete. What's creepier than a doll following you in the hospital with love letters from a stalker that you never want to meet? Solving a puzzle from him on Hard Mode that talks about eating your face. It is truly a terrifying experience just on Normal, but Hard Mode adds a layer of tension and dread you never felt before.

The game even rewards you for playing on Hard Mode. Silent Hill 3 even has Hard Mode as a requirement for a specific ending. There are also special weapons, costumes, and you can try the hardest challenge: a 10-star ranking. Such a feat requires minimal amount of saves, a certain amount of monster kills, killing bosses in an allotted amount of time, total game time, and receiving a specific ending.

Hope you've enjoyed this list of horror game hard modes. Remember, just because you can get bragging rights, doesn't mean it's worth breaking your thumbs. And brain.