Stress Points

When faced with defeat, horror and death, you might accrue some Stress Points. Stress Points are a representation of how stressed your character is.
The higher the stress the more likely you are to fail at doing something, this is shown in-game with a deduction to all Ability checks, Attacks and Saving throws by 1 for each point of stress. However being stressed and full of adrenalin has some upsides, you will deal an extra point of damage for each Stress Point you have. If you accumulate 5 stress, make a DC 16 Composure(WIS+CHA) Check.
if you fail you gain a Short-Term Madness(*), if you fail by more than five you gain a Longterm Madness(**).
If you have 5 stress points at the start of 3 long rests within the span of 5 long rests you gain an Indefinite Madness.
When you finish a long rest you can forgo regaining one hitdie to remove a Stress Point. (Max 1 per long rest)

Recuperating. You can use downtime between adventures to recover from a debilitating injury, disease, poison, or stress. After 3 days spent in relative safety, without taking damage or exerting yourself physically, you remove all stress points.

(*) You can only gain a Short-Term Madness this way once per long rest.
(**) You can only have one Stress induced Long-Term Madness at a time. Gaining a new one replaces the old.

1 Stress point
-1 to ability checks, attacks and saving throws, but +1 to all attack and spell damage.

2 Stress points
-2 to ability checks, attacks and saving throws, but +2 to all attack and spell damage.

3 Stress points
-3 to ability checks, attacks and saving throws, but +3 to all attack and spell damage.

4 Stress points
-4 to ability checks, attacks and saving throws, but +4 to all attack and spell damage.

5 Stress points
-5 to ability checks, attacks and saving throws, but +5 to all attack and spell damage.