It dramatically increases the amount of damage you receive (and dish out), requires the player to keep well nourished, hydrated, and rested while wandering or suffer stat debuffs, and introduces the possibility of illness and infection.
Survival mode is Fallout‘s attempt at leaning more towards a post-apocalyptic simulator than a thrill ride.
But, for all the hours I’ve played, the multiple characters I’ve run, the gimmick builds and odd choices I’ve messed around with, there was one area of the game I’ve never interacted with before – Survival mode. Like a ratty old sweater, it’s kind of comfortable in its familiarity, even if I know I should really just toss it out.