Fate Accessibility Toolkit

Rubber Hits the Road: Conditions and Adaptations

Now, let’s talk about mechanizing (or not) how your character experiences the world. We break this down into conditions—temporary experiences tied to your character’s disability—and adaptive devices, which may involve aspects, stunts, extras, and conditions. The following ideas and suggestions are intended to inspire, rather than prescribe. Use them to develop and describe your own.

Remember, playing a disabled character doesn’t require you to focus on the mechanics of disability. It might extend no farther than the high concept. If you’d prefer, roleplay your chronically ill character’s limited choices rather than trigger Exhausted. Maybe your blind character uses a white cane, but you’d rather use your focus your stunts elsewhere and use it as you might a limb—nothing mechanically significant.

Conditions

Conditions represent temporary states your character will sometimes be in due to their disability. They’re essential to modeling many disabilities and the limitations of some adaptive devices. If you don’t see a condition or device here that recreates the effect you’re interested in, use an existing one as a template to fill with your own ideas. Make your character yours.

What Are Conditions?

A condition is a set of rules that is either in effect or not, based on whether a particular trigger has occurred in the game. A powered wheelchair runs low on battery power if you use it too much before you recharge it. An autistic person might feel overwhelmed in a loud, chaotic nightclub. Many disabled characters might have one or more conditions they are prone to (they might also have none!).

Conditions can be marked, which activates their special rules. These rules are different for each condition, and are described in detail in each condition’s section. Marking a condition activates it, and deactivating a condition is called recovering.

Each condition is rated with one of four ratings for what you have to do to recover from it: fleeting, sticky, lasting, and permanent.

  • Fleeting: You recover from a fleeting condition when you have a moment to sit down, catch your breath, drink some water, or anything else that represents a momentary rest. Alternately, if the condition represents being without an adaptive device, regaining access to (or turning on, repairing, etc.) the device allows recovery.
  • Sticky: Sticky conditions last until you do something specific (often involving a skill check) to recover from it. Each sticky condition’s write-up describes the details.
  • Lasting: Like sticky conditions, you must do something specific to recover from a sticky condition, but it typically takes much longer—usually the end of not this game session, but the next one. Each lasting condition’s write-up describes the details.
  • Permanent: They’re not exactly permanent, but these don’t go away until a major milestone (Fate Core System, page 260).

Please note that the words fleeting, lasting, etc. make no statement about the severity or impact of the condition—just its duration. Even a fleeting condition can be completely debilitating while it’s active.

How To Use Conditions

As examples, we provide several conditions for common situations disabled people might find themselves in. Use them as written, or use them as inspiration to create your own for your own character.

Remember that the point of the Fate Accessibility Toolkit is to help you make and play a character that works the way you want them to, not create a delicate and finely tuned mechanical balance of advantage vs. disadvantage. It is absolutely OK to decide to mark a condition because it makes sense to, regardless of the precise trigger. It is absolutely OK to ignore the recovery rules when it makes sense to.

Not every real-world condition related to a disability has a condition listed here. Some are better modeled as aspects, to be invoked and compelled in the usual way. Some are so severe that it’s essentially a taken out situation—so use it to explain being taken out of a scene. Some are such world-rocking events—a psychotic episode brought on by schizophrenia, for example—that it shouldn’t be triggered by rules, but by the player wanting it to happen to their character. Such events can’t be done justice by a limited set of game rules. If you’re playing a character like this, do some homework and learn what brings those situations on and the different ways they manifest, then roleplay that when you feel it’s appropriate to explore it—and never, ever for laughs.

Example Conditions

Here are a number of conditions players might find useful to make their character’s disability have more mechanical impact. Take as many as necessary to get your character to match what’s in your imagination, but not more—additional mechanical complication has a point of diminishing returns.

Taking a condition means you add it to your character sheet as a condition your character might sometimes have. If you don’t take a condition, that situation might still happen to you but only in a narrative sense. The game rules won’t come into effect unless you choose to make them happen by taking the condition.

Some of these conditions might look a lot like situations that some people who don’t have a medically identified and diagnosed disability experience sometimes. Some otherwise abled people have a tremendously difficult time in crowds, for instance, and react in ways that look a lot like an autistic meltdown. Pregnancy can wallop a person with fatigue that works very much like the Exhausted condition. In cases like this, you could consider having access to that condition even as an able-bodied character—and from a purely rules standpoint, it would work just fine.

Before you do, though, take the temperature of the table. First and foremost, these rules are intended to help disabled players see people like themselves in the game, and giving abled characters access to them might dilute that. Be sensitive to concerns expressed by disabled players, and be prepared to leave conditions to disabled characters.

We can’t possibly provide a condition for every way a disability can knock a person down and make their lives difficult, but we hope what’s here can serve as a starting point. Lots of widely varying disabilities manifest in ways that have similar effects. If the disability you’d like to represent in your game isn’t listed here explicitly, look for effects and conditions that appear similar. Grab a condition that looks like it’s close to what you want and adjust it to work the way you need it to—maybe that’s just changing some words, maybe it’s combining the trigger of one condition with the effect of another, maybe it’s adding a track and rules of your own design. As an added bonus, if you weren’t already, you’re now a game designer!

Exhausted (Lasting) [][][]: This condition covers a wide range of unrelated situations that share similar symptoms. It’s appropriate for characters with any fatigue disorder or chronic pain condition: many chronic illnesses, fibromyalgia, migraines, and chronic sleep disorders. It can also model the depressive episodes of a person with bipolar disorder or major depression or the effects of someone with PTSD encountering a trigger. The Exhausted condition represents more than just being tired; it’s the bone-deep weariness of someone whose body and mind simply can’t, or won’t.

Different people who endure pain and exhaustion have different metaphors for it; some call it being “out of spoons” (spoon theory, created by Christine Miserandino, was originally posted on “But You Don’t Look Sick”—see full resource information in Resources on page XX), some say they’re “turning into a pumpkin” (a la Cinderella’s carriage). Once you’re Exhausted, even the smallest actions require herculean effort and create ongoing costs.

This condition has a track of three boxes—think of these as your “spoons.” You never quite know how many you’ll have available on any given day, so each morning you pre-mark a random number of boxes. Roll one dF:

  • [-] means you immediately mark two boxes, leaving one available.
  • [0] means you mark one, leaving two available.
  • [+] means all three are available.

If you’re using this condition to model a fatigue disorder, each scene during which you take an action requiring significant effort, mark another box. (What qualifies as “significant effort” is up to the player and GM.)

If you’re using this condition to model depression (whether from major depression or as a symptom of another disability such as PTSD), mark a box for each scene in which something triggers your depression—your failure hurting someone else, by seeing “evidence” of your own inadequacy (recognize how depression can warp perception of such things, of course!), and the like.

If you’re using the condition to model bipolar depressive episodes, skip the boxes. If one of your triggers occurs, consider treating it like a compel on your bipolarity aspect and mark all the boxes.

If you get through to the end of the day—meaning, you’re going to sleep—with at least one box still unmarked, clear out the track. Good job managing your spoons!

As soon as you mark the final box, you become Exhausted. While Exhausted, three effects come into play:

  • Whenever you take an action requiring significant effort (again, you and the GM work together to define that), you automatically suffer a one shift hit.
  • You can’t clear your stress (but you can recover from consequences). You must recover from Exhausted first.
  • You can’t clear the Exhausted track simply by sleeping; you must first recover from Exhausted first.

As a lasting condition, recovery doesn’t happen until the end of the next session, and furthermore has two requirements:

  • Your character must sleep somewhere safe and reasonably comfortable.
  • Your character must succeed on an overcome action against a difficulty of +4 using your Physique or Will skill (your choice). You can create advantages using new and existing aspects to make that overcome action easier. For example: Eat a Healthy and Satisfying Meal, or maybe go straight for the Comfort Food. It might be a good idea to make use of your Wheelchair or Scooter whenever possible during the session your character is Exhausted. Get your Weighted Blanket and Go to Bed Early. Let your Supportive Friends bring you a cup of tea.

Once you have recovered, clear the Exhausted track and your stress.

Yeah, the Exhausted condition can be really harsh. It’s designed to do two things: both force players to confront a very and variably limited resource—their own physical or emotional energy —and to encourage roleplaying some sort of self-care in the recovery from the condition.

At first this way of roleplaying disability might feel artificial or “edutainment”-y, but as players become comfortable with the model, making hard choices about how their characters interact with the world won’t feel as hokey—and will help players feel, even if just for a moment, like a disabled character might in a real world setting.

This isn’t recommended for games where players are facing off against the Great Old Ones, or are running for their lives in a superspy story. But in a Leverage style scenario trying to pull off a long con? Those questions could be interesting. More than anything, using Exhausted for a session to get players used to playing disabled characters with the appropriate consequences and choices in place might be a great way to start a campaign.

If you want to model fatigue or depression or PTSD in a simpler way, lean on your aspect establishing your disability. That aspect can be compelled (by the GM, or by you) for a fate point in the way aspects usually are, which gets the same effect with much less bookkeeping and rules. But it also doesn’t quite model the unpredictability and resource management effort necessary to live with depression or fatigue. Each method has its advantages, and the choice is up to you!

Hacked (Sticky) []: This condition is for cybernetic implants and prostheses that have wireless data connections—which is most of them. Mark this condition when an opponent has hacked your device (requiring an overcome action against passive opposition of your Notice skill). Note that you might not know you’ve been hacked, but your GM will. The hacker might steal data that you’re witnessing, or feed you false data.

Determine that you’ve been hacked by telling the GM you’re checking for intruders in your implant, and making an overcome action with your Technology skill (or other applicable skill in your game) against Fair (+2) passive opposition. Recover when you notice and can take some action to evict the hacker’s signal.

Hypomania (Sticky) []: Strongly consider taking this condition if your character is Bipolar (especially Type II; Type I has far more severe mania than this condition represents). Mark the condition when your bipolarity aspect is compelled (see Bipolarity and Aspects, page XX).

While Hypomania is marked, you gain two aspects:

  • Manic Productivity (with one free invoke): Invoke to gain a bonus to solve problems, resist sleepiness, and defend against mental attacks.
  • Faulty Risk Assessment (with one free invoke for the GM): Compel to suggest making risky decisions that you will regret later.

Without treatment, the condition will go away on its own in a few days to a week—but by then, your risky behavior may have you in very, very serious trouble. The only way to make it go away quickly is medication—your character might have a stash, or they might need to seek help from a doctor, which may require a Resources overcome action if you don’t have insurance.

Limited Focus (Sticky) [][][]: This condition models the toll that concentrating on using a complex device can take. Consider taking it if you wear anything with a direct neural input or that requires concentration. Mark one box at the end of any scene in which you make extensive use of the device (you and your GM decide what qualifies). Recover (clear all boxes) when you get a decent night’s sleep. If you mark the final box, you start having trouble focusing on the device, and your pain and lack of concentration render it useless—you suffer the same negatives as the Without My Device condition.

Low On Charge (Sticky) [][][]: At the end of each scene you use a device that runs on batteries (powered wheelchairs, for example), mark a box of this condition. When it’s fully marked, the device starts running in low-power mode. You no longer have access to the stunts and aspects associated with it. Recover (clear all boxes in the track) by swapping out the battery, letting the battery charge overnight, or some similar action to restore full power.

Making Payments (Permanent) []: This represents cyberpunk/science fiction characters with cybernetic sensory implants that they don’t own. If you can’t pay for your implant, take this condition and mark it immediately. Recover only when you pay off the debt—at the next major milestone (Fate Core System, page 260). While this condition is marked, someone else owns the implant in your body. In the most benign cases, it might mean you need to watch or listen to the occasional advertisement streamed through the device directly into your brain. In less benign cases, the owner might capture data you witness through the device, to be used for whatever end they choose, or the owner might demand you perform services for them that you might otherwise not want to perform.

Medical Debt (Lasting) []: Mark this condition when recovering from a moderate or worse consequence representing a physical or mental injury, or when you recover from a disability-related condition by seeking professional medical attention. While in Medical Debt, you automatically fail any actions using your Resources skill. To recover, make an overcome roll with Resources (this one isn’t an autofail) against a passive opposition related to what caused the debt: +2 for recovery from a condition, +4 for a moderate consequence, +6 for a severe consequence. You may create advantages on existing or new aspects to help with that roll, such as Crowdfunding, Side Hustle, Family Money, etc.

Meltdown/Panic Attack/Anxiety Attack (Fleeting) []: Take this condition if your character is susceptible to meltdowns (some autistic people) or panic attacks (some people with anxiety disorders or PTSD). When you established that your character is autistic or susceptible to panic attacks, you discussed the sorts of things that might trigger a meltdown—sensory overload, crowds, specific fear triggers, etc. Mark this condition when an aspect is in play that declares that sort of thing is occurring, AND you mark the highest stress box on your mental or physical stress track.

Every person susceptible to meltdowns and panic attacks has a different reaction, so when you mark the condition choose one or two sets of symptoms you will exhibit:

  • You are unable to speak (but may be able to write notes or sign, if you know how)
  • You are unable to move without assistance
  • You exhibit very strong, muddled emotions that are difficult to control
  • You cannot tolerate anyone (or possibly anything) touching you
  • You are overwhelmed by an urge to flee or get away from the situation
  • You become dizzy and nauseated, feel chest pain, and might pass out
  • You become short of breath and your heart races

To recover from the condition, you must spend a little time away from the stimulus that caused it. Regardless of the particular symptoms, a person experiencing a meltdown or panic attack is under tremendous psychological (and perhaps physical) strain. Effects will likely last for hours after the worst of the symptoms have passed.

Off My Meds (Sticky) []: Take this condition if your character has disabilities or illnesses that they're on medication for. Mark this when you’ve missed your meds one or two doses in a row (depending on your medication). Recover when you’ve resumed taking them and have had a chance to rest to let them kick in again. Compels and invokes are affected in the same way as Without My Device (below).

Without My Device (Fleeting) []: Take this condition if your character is highly reliant on a particular adaptive device (and specify which one). Mark it when you are without that device—it’s stolen, broken, or otherwise out of service for whatever reason. Recover when you regain your device in a useful state.

When this condition is marked, it costs one fewer fate point for the GM to compel or invoke against you any of your aspects related to the disability this device assists with. Free invokes, such as might occur if an opponent creates an advantage on this aspect, are unaffected—in effect, this condition means your opponents always have a free invoke on your disability aspect. You’ll want to get that device back ASAP.

Adaptive Devices

This section tackles the kinds of adaptive devices that your characters might use to get around in an able bodied world, and will help you make decisions like whether or not your blind character has a white cane or a guide dog, or if your wheelchair is motorized or manual. People with different disabilities might use the same adaptive device with minor variations. These choices help you flesh out your character, and bonus, they’re also mechanical advantages for your character.

In the Fate Accessibility Toolkit, there are lots of ways to represent adaptive devices. Any adaptive device from a fidget cube to non-device things like a service animal can be represented by an aspect (using one of your character’s usual aspect slots) or stunt (using one of your character’s stunt slots or refresh points). For more mechanical representation, you can make the device an extra. You can also simply declare that you have one but give it no mechanical backing as a stunt or aspect; in this case it’s simply descriptive and has no rules impact at all (i.e., you have a cane, but its presence or absence never affects dice rolls).

Starting on page XX, we go through a list of possible adaptive devices with suggested stunts and extras you might take or adapt if your character uses the device.

Adaptive Devices and Stunts

Lots of the disabilities discussed in this book list example stunts for adaptive devices—here are some additional examples that you can use as written, or use as inspiration to write your own.

Crutch Shield (Fight): My crutch has a built-in steel shield made from the cuirass of a vanquished foe, granting +2 to defend actions made with Fight vs. attacks from other hand weapons.

Hearing Aid Eavesdroppers (Deceive): My hearing aids are tuned to shift human speech into a frequency range my ears are most sensitive to. Gain +2 to Deceive overcome actions to eavesdrop on people who don’t think I’m paying attention to them or believe I can’t hear them.

Weighted Blanket (Will): My weighted blanket is a great comfort to me. Gain +2 to Will overcome actions to recover from the Exhausted condition, and +2 to Physique create advantage actions to create aspects representing a good night’s rest.

Sword Cane (Fight): The cane I use to assist my mobility conceals a 50 centimeter blade, and I gain Weapon:2 on successful attacks I make with it—and I can still use the scabbard as my cane while I fight.

Tremor Sense (Notice): I have a magically enhanced sense of touch and vibration concentrated in my feet. When barefoot, I can easily sense floorplans and notice solid obstacles by tapping the ground. Additionally, I gain +2 to overcome actions made with Notice to detect ambushes and sense people trying to hide, regardless of lighting—provided the ground is solid. Sand, thick carpet, and footwear more substantial than thin socks interfere with this effect. (Yes, this is a magical adaptive device. Sometimes, though, fantasy tropes can be used to tell stories that aren’t based in the real world and that opens up possibilities.)

Fidget Box (Will): A fidget box is a small plastic cube festooned with buttons and spinners and switches. When I can fiddle with it (in a jacket pocket, for instance) the Meltdown condition can’t affect me until the top two boxes of my Mental stress track are filled, rather than the top one.

Stone String (Will): Because I use a stone on the end of a string as a fidget that helps anchor my thoughts, I can make attack actions with it using my Will skill rather than Fight.

Arm Like a Prybar (Physique): My rigid prosthetic forearm is extremely tough, and gives me +2 to all overcome actions made with Physique to move heavy objects.

Adaptive Devices and Extras

If you’d like to invest a bit more of your character’s mechanics into your device, you can treat many of the devices as an extra (Fate Core System, page 270). Each extra has a permission (typically an appropriate aspect), costs, and benefits (stunts, new skills, etc.).

Not all adaptive devices have extras listed. Some devices, like hearing aids, are better suited to representation through a single aspect. Each adaptive extra has a base cost, and many have varying additional costs depending on how many optional elements you choose.

Skills: You may need to select a particular skill, costing you skill ranks. For example, effective use of a wheelchair might require you to have ranks in Drive (for powered chairs) or Athletics (for manually-driven chairs).

Stunts: All stunts related to the device cost one of your character’s stunt slots or refresh points.

Choosing Your Adaptive Devices

The following table is intended to inspire rather than confine your choices. For instance, many blind people do not have service animals, even more Deaf people do not. But some do. Consider how your character engages with a world designed primarily for those without disabilities and choose adaptive devices that feel appropriate for your character and the setting.

Disabilities and Adaptive Devices

  • Blindness: service animals, wheelchairs, canes, prosthetics, glasses, human assistant, communication device.
  • Deafness: service animals, hearing aids or cochlear implants, communication device.
  • Mobility: service animals, wheelchairs, canes, prosthetics, human assistant.
  • Dwarfism: service animals, wheelchairs, canes, prosthetics, human assistant.
  • Chronic illness: service animals, wheelchairs, canes, human assistant.
  • Synesthesia: glasses, earplugs.
  • Autism: service animals, human assistant, communication device, coping device (fidgets or anchors), earplugs.
  • Depression: human assistant, communication device, coping device.
  • Anxiety: service animals, human assistant, communication device, coping device, earplugs.
  • Schizophrenia: human assistant, coping device.
  • Bipolar: human assistant, communication device, coping device.
  • PTSD: service animals, human assistant, communication device, coping device, earplugs.

Guide Dogs and Service Animals

Some characters—such as those who are blind, who are epileptic or live with seizures, or who have anxiety or PTSD—might have service animals who work for them to make their lives easier. A character with a service animal can use that animal (most often a dog) in several ways as a mechanic to negotiate with their disability in game.

  • A blind character with a guide dog, for example, can navigate spaces faster than they would with a cane (page XX). The dogs give them a better sense of their environment, because the dog can see.
  • A character with PTSD or anxiety could have a dog who is trained to help them navigate an anxiety attack, thus lessening the effects and repercussions of such an incident.
  • A service dog or cat for a character with seizures would be trained to tell a player character when they are having a seizure.
  • A service dog for someone who is Deaf could be trained to tell someone when their phone is ringing, if they’re being followed, or if someone is at the door.

An important note about guide dogs and service dogs in general is that they are still dogs with dog brains. Sometimes, they’re going to act like a normal dog would—and that’s a complication, isn’t it? This could be even more true for less traditional service animals, like a monkey or a ferret.

You should describe some basic things about your service animal. What’s its name, and what breed is it? What is its personality like? What services is it trained to provide? Service animals can be trained to perform all sorts of actions. You don’t need to represent them all with a stunt—any guide dog will stop you at a busy street curb. Any suitably trained service dog will help you pick up your house keys. Very few are trained for combat—the dog doesn’t get a separate turn in fights, and doesn’t make attacks. It might defend you from attackers, however.

Perhaps the easiest way to model a service animal is for the player to devote an aspect to it (My Guide Dog, Jonesy) and to rate that animal as a skill on the character’s pyramid (Good (+3) Jonesy). Whenever the character has to make a roll involving using that service animal, such as using Jonesy to navigate a particularly complex area, they roll that skill. Most of the time, don’t bother with the roll.

Extra: Service Animal

Permission: An aspect establishing a suitable disability—usually blindness, but other disabilities can also benefit from a service animal.

Cost: Skill ranks in the skill Service Dog—add this skill to your skill array as you would any other skill. The extra also uses one of your stunt slots or a point of refresh.

Skill: Service Dog. Use it whenever your service dog does something within a service dog’s purview: sensing danger, intimidating foes, fetching dropped items, etc. You cannot make attack actions with this skill.

Aspect

Compose an aspect like My Service Collie Jack:

Invoke: Jack snarls menacingly at a threatening goon! Jack’s sharp senses notice approaching danger.

Compel: Jack’s in danger and needs to be rescued! That lady dog sure does smell nice and Jack really wants to get to know her better…

Stunts

You may choose one free stunt from this list of examples or compose your own.

Don’t You Hurt My Friend: Jack willingly faces down those who would attack you. You may roll your Service Dog skill to defend against attacks against you made unarmed or using hand-to-hand weapons.

Table Top: You give Jack a subtle hand signal, and he maneuvers behind an opponent’s knees. You give that opponent a shove, sending them tumbling. Gain +2 to overcome or create advantage actions using your Service Dog skill made to trip a standing opponent.

Light-“Fingered” Pooch: Jack is trained to find and retrieve numerous common items—the training was to help you when you misplace your cell phone, but it turns out he’s great at petty larceny. Roll your Service Dog skill with a +2 bonus to overcome actions when picking pockets, burgling from purses, or silently nicking items out of a drawer.

Variations

Other Animals: Instead of a dog, use a cat or monkey—but make sure you read up a bit on non-dog service animals to get a feel for what they’re capable of.

Fantasy: Instead of a dog perhaps it’s a tiny dragon, magical invisible force, or a demon or spirit you’ve bargained with.

Sci-Fi: Instead of a dog perhaps it’s a robot, a synthetic life form genetically engineered to look like a dog, or an animal of alien origin.

Service Animals in Conflict

If a character has an omnipresent service animal, realize that causing harm to that animal in the game might be unpleasant or traumatic to the player—and to other players around the table. As such, it’s often best for the animal to “fade into the background” when violence starts; it doesn’t attack enemies, and they don’t attack it. Plus, most service animals are trained to not engage in violence, so their instinct is to get out of danger—and to take their human with them!

Wheelchairs

Wheelchairs are vehicles. That’s the first thing to understand when you play a character who uses one. The second is that you have some decisions to make: based on the disability that your character has, you need to select what kind of chair your character uses.

A paraplegic can use either a manual wheelchair or a motorized wheelchair, whereas a quadriplegic is only able to use a motorized chair in order to move around. Someone with fatigue or chronic pain may need a scooter while out and about, but walk with a cane or walker while at home where they can rest when necessary. What are your character’s needs? What kind of chair will best suit those needs?

Types of Wheelchairs

Manual wheelchairs come in a few different types, but they’re all the same in terms of propulsion: They are moved by the user’s arms or sometimes feet, or are pushed by another person. They can be super lightweight, clunky, brightly colored. They can have rims. They can be designed to support participation in various sports and other physical activities (hand-operated bicycling, contact sports like “murderball,” team sports like volleyball or basketball, etc.) or for specific kinds of terrain (e.g., sandy, muddy, rocky).

When designing your chair, think about the function of the wheelchair and what kind of terrain it is intended for. It may also be helpful to know whether it has handles for assistive pushing. Everything else is narrative detail about how your chair looks, etc.

Mechanical chairs are bigger and heavier, and they do not, for the most part, fold. They often have a sort of evil mastermind or borg chair look to them. They are generally controlled by a manual joystick and buttons to adjust chair height, tilt, etc. Users are significantly faster and more independent than those with a manual chair, but manual chairs are more portable and easily accessed. Motorized chairs also tend to perform poorly in soft terrain.

Players should consider perspective when playing a character who is a wheelchair user. A manual wheelchair is usually at about crotch height with the rest of the world. Great for checking out people’s butts, but less great if you want someone to notice you when you’re wheeling down a busy street. On the other hand, wheelchairs are also something people like to avoid looking at—because they don’t want to stare. Because of where the average person’s focus is, a wheelchair can be almost invisible, and by extension, the person who uses the chair becomes invisible too.

Characters with any kind of wheelchair have less access to things like bars, counters, and high shelves. Motorized wheelchairs are often higher off the ground than manual ones, so that might change what you can or can’t reach, and some include a seat lift option to reach even higher. Wheelchair users often carry a “grabber” to mitigate the challenge of reaching up or down. The spatial experience of sitting down in a wheeled chair while interacting with the world can be compared to the experience of an adult who is the height of a nine year old.

Wheelchairs can have different kinds of tires and wheels for different purposes. It’s worth a quick search to see what your character’s options might be. There are wheels and tires for beach adventures, offroad trekking, handcycling, court sports, racing, and so forth.

Extra: Hand-Propelled Wheelchair

Many people with mobility impairments use wheelchairs, but some people really become artists with their chairs. That’s you. You don’t have to be a full-time user—many wheelchair users can walk well enough, but require the option of wheeling around when necessary; this doesn’t mean they can’t be really good with their ride.

Permission: An aspect establishing a appropriate disability.

Cost: One of your free stunt slots or a point of refresh. Athletics skill of at least Fair (+2), reflecting the physical strength and endurance that develops from frequent manual wheelchair propulsion.

Aspects

You may compose an additional aspect like Hell on Wheels or Wheelchair Marathoner. Talk with your GM about how you imagine those aspects being compelled and invoked.

Stunts

Choose two stunts from this list. Additional stunts related to your wheelchair must occupy your character’s regular stunt slots or points of refresh.

  • The Need For Speed (Athletics): You’re the fastest around when it comes to human-powered travel. When you’re in your chair, you gain +2 to all overcome actions made with Athletics in chases or races when your opposition is on foot.
  • Crowd Control (Athletics): You know how to avoid traffic, pedestrians, and cyclists. When you’re trying to move fast in your chair, aspects reflecting physical obstacles (crowds, pallets of cargo, spilled garbage cans, etc.) can’t be invoked against you—unless they outright prevent movement (locked doors, walls, steep stairs, closed gates).
  • Offroad Chair (Athletics): Your chair is equipped with large wheels intended for offroad travel. You gain +2 to all overcome and create advantage Athletics actions related to movement and positioning when on grass, gravel, sand, snow, etc.
  • Bottomless Saddlebags (Resources): That bag slung across the back of your chair always seems to have the perfect thing for any occasion. Gain +2 to create advantage actions with the Resources skill to create situation aspects for having exactly the right tool, gizmo, item, or supplies.
Conditions

If you rely on your chair to the point where you’re at a substantial disadvantage without it, take Without My Device (page XX).

Extra: Powered Wheelchair/Scooter

If your wheelchair or scooter has a motor, this might be the one for you. Cool pair of aviator sunglasses optional.

Permission: An aspect establishing an appropriate disability.

Cost: One of your free stunt slots or a point of refresh. Drive skill of at least Fair (+2), reflecting the practice you get piloting your chair.

Special: Use the Drive skill to operate your chair—where someone on foot would roll Athletics, you roll Drive.

Aspect

Compose a free aspect like Mozart in a Go-Kart or Wheels for Any Occasion.

Stunts

You may take two stunts for free, chosen from this list or created by you. Additional stunts related to your chair must occupy one of your character’s free stunt slots or a point of refresh.

  • Made a Few Special Modifications Myself (Drive): You (or your mechanic) have upgraded the drive motors and suspension on your ride to give it some real top end velocity. When you’re in your chair, you gain +2 to all overcome actions made with Athletics in chases or races when your opposition is on foot.
  • Gunship (Drive): Your chair has an axial-mounted submachine gun. When you use it to make an attack with Drive, gain Weapon:2 on successful attacks.
  • Amphib (Drive): Your chair is designed to navigate water as easily as ground—it can traverse calm bodies of water.
  • Solar Charger (Drive): You have a highly efficient solar charging station for your chair. If you spend a scene outdoors in bright sunlight, the track of the condition Low On Charge clears. You can also use the charging station to charge other devices.
Conditions

You must take the condition Low On Charge (page XX). If you rely on your chair to the point where you’re at a substantial disadvantage without it, take Without My Device (page XX).

Variations

Fantasy: Instead of wheels, a flying carpet or a small but strong extraplanar pack animal to handle curbs and stairs

Sci-Fi: Instead of wheels, repulsorlifts or leg-like mechanisms to handle curbs and stairs

Canes

The use of a cane may be temporary or permanent. Selecting what kind of cane your character might use is important, not just to how their character deals with their disability, but also as a way for them to express their character. Canes are also blunt force weapons. A straight up and down wooden cane can be used to bash down a person or a door, a white cane might secretly snap out to be a set of nunchucks, and of course there are many variants of the swordcane—a cane can hide blades, poisons, and many other things.

Dr. Gregory House had a cane decorated with flames going up the side, whereas a hacker elf might have a cane made of pure steel with a glowing internal shaft. Your character’s cane is an extension of their body, not just in terms of how it supports them, but also in terms of how it displays their nature.

Types of Canes

Canes come in a few different varieties.

There are stabilizing walking canes. A character who uses a regular walking cane might have a permanent injury causing a limp, they might have a prosthetic leg which requires extra load bearing support, or they might have a seizure disorder or pain disorder.

For other disabilities, stabilizing crutches may be more appropriate. Characters with arm braced (cuff) crutches are typically those with disabilities like Down syndrome, cystic fibrosis, or any other condition which might affect their balance or ability to bear weight, including pain conditions.

And then of course there’s the white cane for characters with low vision and blindness.

White Canes

Rather than a guide dog (page XX), characters with low vision and blindness might use a white cane instead. There are three types of white cane that your character might select from.

  • A standard long white cane. Completely white, or white until the last foot, which is red. It doesn’t fold, it doesn’t do anything fancy, it just is. These generally have a metal tip on the end, and are free from the National Federation for the Blind in the United States. (But only get one if you’re actually blind, folks.)
  • A folding white cane. These are made out of either aluminum or carbon, fold into 6 distinct sections, and can be stuffed inside a backpack. They fold up and snap out kind of like nunchucks. You’ve seen these on shows like Dare__devil.
  • Stabilizing white cane. This is painted like the red and white cane, but has the shape and use of a standard weight bearing walking cane for people with multiple disabilities.

To play a character who uses a white cane, you have to understand a little bit about how it works. The user picks up the cane in their dominant hand, and sweeps (the technical term is “scans”) it along the ground; the tip of the cane touching the ground acts as a radar or sonar reader. As the cane sweeps across the ground, it gives the user a sense of what kind of ground they’re walking on, bumps into objects telling the user to stop and find out where that object is so that they can move around it, and catches in sidewalk cracks telling the user where to step carefully. It also tells them where there are stairs and curbs. Basically, a white cane user understands their environment through the feel of the cane. Someone who is well trained in the use of the cane almost uses it as a new sense, a little like tactile echolocation.

Weaponizing a cane is something you can do fairly easily by describing it as an aspect (Spiky End Point comes to mind) and talking about what makes it a good weapon.

Alternately, it could be described as a stunt:

  • My Trusted Cane (Fight): Because I always have my heavy walking cane with me, I get +2 to defend actions with Fight made against melee attacks.
  • “Upgraded” White Cane (Fight): Because I “upgraded” my telescoping white cane with a sharp point, I get +2 to attack actions made with the Fight skill, when my opponent doesn’t expect my attack.

Extra: White Cane

Permission: An aspect establishing a blindness disability.

Cost: This extra occupies one of your character’s stunt slots or uses a point of refresh. You must take the Without My Device condition.

Aspect

You may compose a free character aspect like Cane Expertise which does not count against your usual aspect slots.

Stunts

You may choose two free stunts from this list (or compose your own).

  • Effortless Parry (Fight): You know exactly how to put an attacker off balance with a simple flick of your cane. You gain +2 to defend actions with the Fight skill when an opponent attacks you with a knife, sword, club, fist, or the like.
  • Stun Stick (Fight): The handle of your cane conceals a powerful electrical stunning device, which delivers a viciously painful shock through the cane’s tip. Once per scene, you can apply Shocked and Stunned to the target of your successful Fight attack made with the cane.
  • Trapfinder (Notice): You have optimized your cane for locating traps, snares, false floors, and other pitfalls you might encounter while exploring ancient temples and ruins. Gain +2 to overcome actions with Notice to find traps.
  • Step Lightly (Stealth): Your touch with the cane is delicate enough to give you a sense of where to step to be as quiet as possible. Gain +2 to overcome actions with Stealth when opposed by an opponent’s Notice.
Conditions

You must take Without My Device (page XX).

Variations

Fantasy: The cane might be a wizard’s staff or druid’s shillelagh.

Sci-Fi: The cane might be a force projector or energy beam rather than a stick made of solid matter, or might contain other hidden devices which should be represented by appropriate stunts.

Prosthetics

Prosthetic limbs are a fairly common type of disability that we often don’t notice because of how they look in modern day. Common because military service can often result in the loss of a limb, common because of celebrity athletes whose cheetah feet have become part of their cult of personality. If you saw Mad Max Fury Road, you saw Imperator Furiosa’s incredible wrench hand. People with prosthetic arms, legs, hands, eyes, etc., face a few challenges, most of them related to navigating a world that isn’t designed for their bodies. Hands may not be able to open doors (if there were a case for a service velociraptor anywhere in this book…), legs may be caught in things, limbs might come off because of a faulty joint. Even eyes have prosthetic limbs available to them—Elsa wears one every day, called a scleral shell. Technology here is an advantage, a tool, and sometimes even a nifty gadget.

Characters with prosthetic limbs might wear cheetah feet or blades for running; they might have a 3D-printed hand or a fully articulated steam powered hand. Considering possible leaps and bounds in design and biotech, how a prosthetic might appear in your story makes it a little more unique and exciting.

Extra: Cybernetic Limb

A cybernetic limb is suitable in many science fiction/cyberpunk settings. It’s made of and powered by exotic materials and is controlled by a direct neural link—possibly directly wired into the wearer’s nervous system, or possibly wirelessly linked to a brain implant. Be careful not to erase the disability—pay attention to the fatigue and pain such a device might cause with extended use.

Permission: An aspect establishing an appropriate disability.

Cost: One stunt slot or point of refresh. Also, justification for having paid the immense cost of such a device—an aspect establishing your character as wealthy, a Resources skill of at least +3, a debt owed to a powerful creditor, etc. If you can’t pay for it, take the Making Payments condition.

Aspects

Compose a free aspect like The Best Hand Money Can Buy or I Don’t Even Own My Own Leg.

Stunts

Choose two free stunts from this list, or design your own. Any additional stunts you take regarding this device each come at the cost of one of your stunt slots or a point of refresh.

  • Smuggler’s Compartment (Deceive): Your prosthesis has a concealed compartment large enough to contain a tool, small weapon, or some other contraband where it is invisible to scanning. Spend a fate point to have a device where you shouldn’t have it.
  • Frickin’ Lasers (Shoot): Your prosthesis contains a built-in blaster, giving you Weapon:2 when you make Shoot attack actions with it.
  • Autoinjector (Physique): Your prosthesis contains a system that automatically dispenses a bioengineered steroid that kickstarts your physical healing. Once per session, at the cost of a fate point, you can reduce the severity of a moderate consequence that’s physical in nature to a mild consequence (if your mild consequence slot is free), or erase a mild consequence altogether.
  • A Single Bound (Athletics): Your leg is enormously strong and allows you to make superhuman leaps. Gain +2 to overcome actions made with Athletics related to climbing and leaping.
Conditions

Take one of the following conditions; an extra one or two would be appropriate if you choose: Exhausted (page XX), Hacked (page XX), Limited Focus (page XX), Low On Charge (page XX), Making Payments (page XX).

Variations

Fantasy: A magical or enchanted limb

Extra: Cybernetic Sensory Implants

Cybernetic or bionic sensory prosthetics are a standard trope of cyberpunk and science fiction settings. They’re usually manufactured devices, made of exotic materials and full of electronics. The way many people think of these devices makes it very easy to ignore your character’s disability entirely—it’s a delicate balance to make them useful without making them erasing.

Make sure you establish with the GM what it can and can’t do, or what trouble it brings you. Does that cybernetic eye fail to interface properly with the part of your brain responsible for facial recognition? Maybe an intermit malfunction translates text you read with it into a language you don’t understand. Does the aural implant require expensive recalibration on a regular basis? Does your corporate sponsor only lease you the implant? Does the device give you crushing headaches, requiring you to deactivate it when it’s not essential?

Permission: You must have a disability aspect that corresponds to your implant.

Cost: One stunt slot or point of refresh. Also, justification for having paid the immense cost of such a device—an aspect establishing your character as wealthy, a Resources skill of at least +3, a debt owed to a powerful creditor, etc. If you can’t pay for it, take the Making Payments condition.

Aspects

Compose an aspect like The Company’s Robotic Eye or Infrasonic Implant.

Stunts

Choose two stunts for free. Additional stunts require use of your character’s stunt slots or refresh.

Expanded Frequency Range (Notice): The device allows you to see or hear beyond typical wavelength limits—infrared or ultraviolet for eyepieces, or infrasound or ultrasound for ear implants.

Extended Range (Notice): The device allows you to zoom in to distant events as if it were a telescope, or hear minute sounds at a distance.

Embedded Recording (Notice): On mental command, your device can record what it sees or hears, and wirelessly upload it to a server. It can play back directly into your mind what it hears or sees.

Conditions

Consider taking the conditions Making Payments (page XX) or Hacked (page XX).

Other Senses

Blind characters will build extensive mental maps to find their way around cities that they navigate—for example, a character who has lived in one city for part of their lives might take a minute to re-orient themselves into a tactile map of the city, but once they understand their directions, they can run off and go anywhere. A blind person often has some kind of system for how they get around, whether it’s through landmarks (low vision characters can still see) or by the way the street changes from cobbles to bricks in the span of a block.

With the advent of smartphones, characters also have the option of headphones reading them the directions they need, but a blind character might also navigate using very specific directions provided by sighted characters using no visual landmarks, only counted block numbers.

Characters who are blind also likely navigate using what they feel under their feet. A character might know what room they’re in based on whether a room has tile, carpet, or hardwood. The sense of what’s below them might very well give them a better understanding of where they are than a sighted person.

GMs should be aware of the surroundings they give their PCs, knowing what their disabled characters would be aware of that able bodied PC’s might not be, such as the kind of floor, or whether there’s a wheelchair ramp into the library. Access and the lack of it are important things to know about your setting.

Some blind people can echolocate. They’ve taught themselves how to do this by clicking their tongues and navigating based on the way the sound comes back to them. It’s actual echolocation. Not every blind person can do this, but those who can are easily findable on the internet to learn more about the how. If you play a character with this particular ability, you likely won’t use a cane or a dog, but you also aren’t likely to be multiply disabled because your ability to hear should be exemplary in order to master this particular skill, and a wheelchair or cane might make sound distractions which would affect your ability to echolocate.

Glasses

Glasses and other corrective lenses, such as contact lenses, are perhaps the most common adaptive devices. If you don’t use them yourself, you almost certainly know someone who does. Especially as they get older, people often end up with several different lenses to solve different vision issues. Glasses and contact lenses aren’t perfect solutions—they can be uncomfortable, they often don’t fully solve the problem, they’re inconvenient, they fog up with annoying regularity—but they’re so common that we often hardly think of them as adaptive devices.

Even if your character needs glasses, it may not need to be more than a narrative detail that isn’t reflected in the mechanics. If you want your glasses to really matter to your character, consider an aspect like I Look Awesome in My Nerd Glasses, which could be invoked when you play on the stereotype of people in glasses being smarter or more serious, and compelled when your glasses fog up, break, or are misplaced.

To make your glasses an extra, see Cybernetic Sensory Implants on page XX.

Corrective Lenses

A variety of vision problems—such as nearsightedness, farsightedness, astigmatism—can be helped with corrective lenses. Even people with relatively good vision may require corrective lenses to help them see in certain situations or to improve focus issues, but they can function without the lenses if they choose to. Focus issues cover a wide range, though, and many people can’t do much without their glasses. Some can’t really see anything without corrective lenses.

Sunglasses

While we should all wear sunglasses to protect our eyes when the sun is bright, for some people it’s a necessity. Photophobia—a sensitivity to light—is a symptom of many illnesses, headaches, and conditions. It can be a side effect to certain medications. People with light colored eyes are frequently sensitive to bright light, especially sunlight. Blue light from computer screens or harsh indoor fluorescent lighting irritates many people. Some people are bothered by any kind of light. Dark or colored lenses of varying types can help deal with these issues by blocking or reducing certain types of light.

Protective Lenses

Having glasses in front of your eyes inherently protects them from being hit by something, thus safety glasses are required when working with machines, chemicals, etc. If your eyes have difficulty reacting quickly, however, protective lenses may be a daily tool. For instance, if you’re blind in one eye, your depth perception and side vision are impaired. The blink reflex may be slowed or nonexistent. Protective lenses help make that slow reflex less of a danger.

Color-Corrective

Color-corrective glasses for those who are colorblind do exist. They’re not covered by any insurance or discount program, and they’re a little expensive ($400 or so), but they exist, and they mostly work (though not for everyone). They help the wearer distinguish colors more easily, and they make everything a little more vibrant, but they’re not a perfect solution. It’s a bit like having a prescription for regular glasses that doesn’t quite get you to 20/20.

Hearing Aids & Cochlear Implants

Hearing aids and cochlear implants were covered a bit in the Deafness chapter (page XX) but here’s some extra material you might want to know about.

Both hearing aids and cochlear implants can be used to manage hearing loss. A character who uses either of these kinds of aids may not require mechanics beyond a related aspect, but it will change the way that your character interacts with the world, and there are rules.

A character who wears a hearing aid in one or both ears only has the benefits of that aid when the hearing aids are in. A character who takes their hearing aids out at night or to swim might not hear something when the aid is out.

One of the complications of having an aid is that they are breakable, whether because you set your hearing aid on the table and a dragon ate it, or because you accidentally went swimming with a Siren. Neither cochlear implants or hearing aids are impervious to water.

Hearing aids and cochlear implants are also not a perfect solution. Hearing aids are like a small microphone in your ear; depending on the kind you have (in the ear, behind the ear) you might have a microphone that faces front, and you can’t hear people behind you, or you might not always hear people because the wax trap is full. Cochlear implants are not an exact replica of hearing; for reference—we’re not kidding—go to the Wikipedia entry on cochlear implants where you can listen to Beethoven’s 5th Symphony as heard through one. It gives you an idea of what that’s like.

A hearing aid is also a tool that you have to learn how to use; a character who gets one put in has a learning curve for how they hear, as well as learning what words sound like. They might be surprised by how loud the sound of crumpling paper is, or that bacon makes a sound when it hits a frying pan. A hearing aid (except in the far future) is not an exact method for adjusting someone’s hearing.

To make your hearing aid or implant an extra, see Cybernetic Sensory Implants on page XX.

Service Humans

Almost any disabled person may rely on steady assistance from one or more people. In some cases, such as through organizational requirements (sign language interpreter) or government/private funding (group home care assistant), the service human officially assists with designated tasks. In other situations, the role of “service human” is filled by family, roommates, or friends. In considering which person or persons may regularly act as your “service human,” evaluate the tasks for which regular assistance enables you to navigate a world built primarily for the able-bodied.

Official

As the chart on page XX indicates, almost anyone may have a service human, but you are more likely (although statistically still unlikely) to have some form of official assistance as a blind person (transcription, navigation), Deaf person (interpretation), someone with a mobility disability, or dwarfism. For example, people with mobility disabilities can lead generally self-sufficient lives but may have an assistant who receives a small salary to assist them with bathing, using the toilet, shopping, cooking, and other tasks. The service human may be a roommate in a group living situation or come by regularly to assist with specific tasks, such as your evening bath. In other cases, this role may be filled by a member of their family. Those with mental illnesses are more likely only to have official service humans in the form of therapists.

And Otherwise

Whether through family or as part of a community, unofficial service humans provide reliable assistance while not receiving any payment for the role. It may be the friend or partner around whom you may safely melt down or who stays alert to disengage triggers before you reach meltdown point. Or it could be the classmate who has agreed to email you typed notes so that you can listen in class and not worry about your braille keyboard.

Extra: Personal Assistant

Permission: A suitable disability as established by one of your character aspects.

Cost: One of your stunt slots or a point of refresh. Skill ranks, a rating of Good (+3) in the skill My Assistant.

Skill: My Assistant. Use this skill for any action your service human undertakes that is in one of their identified areas of competence—essentially giving you those skills at +3, as long as your assistant is around.

Special: Identify two Fate skills that your service human is trained in. Also specify what hours they have off.

Aspect

Write an aspect naming and describing your assistant. Invoke the aspect to hire the assistant to work overtime and be there during an off-hours scene; a compel of the aspect might establish that the current scene is happening during the assistant’s off hours.

Stunts

You get no free stunts with this extra.

Brian makes a character for a modern-day Mythos horror game—James Martinez, an occultist with a popular podcast—and decides he wants the character to have a multiple sclerosis-induced mobility disability. He takes the extra Personal Assistant, and decides that his assistant is a former MMA fighter and fitness instructor. Brian adds Patricia Cooper, Personal Assistant to his character sheet and writes the skills “Fight, Provoke +3” next to it. She’s off Mondays and Tuesdays, and evenings after 3. Brian also announces that she’s great at making healthy and delicious smoothies, but that’s not going to have any rules impact.

Variations

You might be tempted in some fantasy or historical games to declare that the assistant is an indentured servant or an enslaved person. Please stop, think about that again, and then don’t.

Fantasy: A demon you’ve made a bargain with, a construct or familiar

Sci-Fi: A robot, whose off-hours might be when they’re charging. Or, if it’s a sapient AI, they should get time off too, right?

Communication Devices

Many people with severe motor control impairment, or autistic people experiencing a meltdown, are unable to speak; fortunately there are communications devices that range from very simple (white boards, plastic letter boards) to exceedingly complex (the sophisticated computerized system that Stephen Hawking used, which allowed him to deliver lectures about physics and calculus using a sensor that detected movement of his cheek). A d/Deaf character might always carry around a small paper pad and pen to ease communications. In the middle of a Meltdown an autistic character may converse in sign language with her service human or pull up an app which simulates texting and completely avoid eye contact as she passes it to others. The extra below is about devices that lean toward Professor Hawking’s system, although yours might run on spells rather than batteries. If your character is looking for something in between the two, check out the TV show Speechless for an example of a laser pointer and board style communication system.

Extra: Electronic Communication Device

Permission: A suitable disability as established by one of your character aspects.

Cost: One of your stunt slots or a point of refresh.

Aspects

Compose an aspect such as NeuroComm 3000 Communicator or My Computer Speaks For Me.

Stunts

Choose two free stunts from this list. If you take more, you must use your character’s stunt slots or points of refresh.

  • Audio Out (Lore): Your speech system can output any sort of sound you wish, and loudly. Gain +2 to create advantage actions when making sounds is helpful: a piercing siren, a disconcerting subaural rumble, etc.
  • Computerized Linguist: Not only can your speech system output spoken words in any of several dozen languages, but the computer can render speech you hear as text and translate it into a language you understand. With this computer, you will always understand and be understood.
  • Mimic (Deceive): The speech synthesizer can mimic the voice and inflection of anyone it hears for at least a minute. Gain +2 to Deceive overcome or create advantage actions when you’re trying to impersonate the voice of someone the system has heard.
  • Etiquette & Protocol (Rapport): The system that translates your inputs into text is sophisticated enough to make wording suggestions and provide simple cultural context. Gain +2 to overcome and create advantage actions with Rapport when you’re persuading strangers to do you a favor or regard you as a friend.
Condition

Take the condition Low On Charge (page XX) and possibly Hacked (page XX).

Assistive technology also includes a multitude of virtual tools that can be controlled using electronic devices such as smartphones, tablets, communication devices, some powered wheelchairs, etc.. For example, useful phone apps include magnification, voice recognition, text-to-speech, remote control capability, and so forth. “Smart” devices can be used to control automated house features such as temperature, lights, doors and locks, sound systems, alarm systems, and more.

Coping Devices

From weighted blankets to chewable necklaces to fidget spinners, these are your tools for staying calm in tough situations or recovering afterward. Your coping device may act as an anchor, like a talisman you use to remind yourself that depression lies. These may give you a direct advantage against mental stress, or come into play in the form of stunts (see Adaptive Devices and Stunts, page XX).

Medications, Exercise, etc

There’s a lot you can do for depression and anxiety—medication, therapy, light boxes, and there will likely be more for the future. If you have aspects like Light Box, My Therapist Is On Call, or Scrip For Citalopram, you can invoke them to help recover from consequences and conditions.

Never suggest that a character will get better with some outdoor time and some exercise and some relaxing yoga. This is a harmful trope that needs to die. Depression and anxiety are frequently caused by imbalances in your chemical system, or issues with your brain and the way that it functions.