Stress persists on the heroes, rendering treatment mandatory in order to make use of a stressed hero again without heavy drawbacks, and making difficult decisions such as retreating from a failing expedition more grave, as fleeing from fights and missions also stresses out the heroes.

When returning to the Hamlet, stress levels are capped to 100. Unlike combat damage, stress is not fully healed when finishing a mission. Many negative quirks will increase the amount of stress suffered by a hero in certain situations, as will the drawbacks of many trinkets. Heavy stress damage will also be applied, together with health damage, when failing to satiate a hungry party, when removing obstacles without the use of a shovel, or when witnessing a comrade either reach Death's Door or die.

Extra stress damage is suffered if walking backwards through a corridor, when getting hit by traps, or through some interactions with curios, as well as when prolonging a fight excessively.

A small amount of stress is also gained when entering a dungeon (depending on its level and the hero's resolve) and while travelling through it, and its magnitude is greatly influenced by the amount of light that the adventurers have at their disposal during any stressful event. Stress is mainly gained by fighting during expeditions, through monsters' critical strikes and some particular attacks that specialise in dealing stress damage.

Stress skills darkest dungeon