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Afraid of Monsters: Director's Cut focuses on the troubled and drug-addicted David Leatherhoff who heads to Markland Hospital for rehab to fight his addiction against a mysterious drug. In the bathroom, he finds a bottle of pain-killers and takes them, sending him into a drug-induced nightmare.
He wakes up hours later, and finds that it's night and the hospital is closed, almost pitch black, and overrun abominable and hostile creatures known as Twitchers. Arming himself with a knife, handgun, and a shotgun, David ventures down into parking lot and sewers, blasting his way through armies of monsters, and is chased by the police into a forest. After a series of choices the player can pick four endings to conclude David's nightmarish tale. The first three end with David realizing he was actually murdering dozens of innocent civilians and animals and he simply hallucinated them as monsters, ending with him getting arrested (ending one), getting questioned (ending two), or hanging himself in his prison cell (ending three). The forth ending reveals he was simply dreaming during a drug overdose and a group of doctors barely managed to save his pulse in a patient room.
Afraid of Monsters is considered a very difficult game where you're given just enough ammo and flash-light batteries to survive whilst a wave of major-damage-dealing enemies who possess high HP are thrown at you. Wasting a single bullet or battery can cost you your life, so conserving your supplies extremely carefully is a necessity.
The game opens with a camera roaming the halls of Markland Hospital, and its guide concludes in the bathroom where David Leatherhoff stares at a bottle of pills on the sink, hatefully ruminating about his addiction to them. The stall door behind him randomly opens, and he goes to investigate. Suddenly, he is dipped into this trippy nightmarish land that he must navigate through twisted corridors, trails of red dots, and sketched mazes. He is teleported back into the bathroom where he assumes he passed out, before exiting and seeing he was unconscious for hours and the hospital is closed, as it's night.
After arming himself with a kitchen knife, David's exit is blocked by sparking wires draping from the light fixtures, forcing him to go down into the basement and shut off the facility's power. When he does so, zombie-like creatures known as Twitchers spill out of the shadows and attempt to murder him, forcing him to kill them with his knife and newly found handgun. His armory progresses once he wields a shotgun, and he ventures deeper into the hospital to the underground parking lot, which leads outside to the fog-encased apartments and parks. His journey also cuts through the sewers, where he encounters several other monsters to kill.
David can't tell whether or not this is in his head or reality, but notices either way they're growing more and more powerful/terrifying. Walking down a narrow road, he is chased into the forest by a car driving down the road. Finally, the player is forced to pick four endings. In the first, he wakes up in a house littered with the corpses of innocent civilians, and sees loud police cars surrounding the house. He exits the house with his hands behind his head, surrendering. The second ending is where he's being questioned by a police officer in an interrogation room, where he buries his head in his hands in shame, yelling how sick it was that he murdered several innocent people when he thought they were monsters. The third ending is a police officer reading a newspaper titled "Psychotic Claims Over 27 Victims" before going to David's cell to see he hung himself. Finally, on the forth ending, it is revealed it was all just a drug-induced dream and some doctors barely manage to save David from a brutal drug overdose.
- Twitchers - Reskins of the Zombies from Half-Life, but are much faster. They appear as bloodied mangled humans with their heads violently lashing back and forth, thus their name.
- Handcrab - Reskins of the Headcrabs from Half-Life, being eyeless human heads with hands gouging out of their gaping mouths that they use to move and jump around with.
- Wheelchair Twitcher - A slow wheel-chair bound Twitcher that spews blood in all directions when David nears it.
- One-Eyed-Dog - Reskins of the Houndeyes from Half-Life, being black dogs with one-eyed human heads that charge at David before emitting destructive red shockwaves.
- Abomination - Reskins of the Vortigaunt from Half-Life, being large black masses of legs with a human head that spits balls of poison that drains David's health for a few seconds.
- Bleeding Specter - Reskins of the Alien Grunts from Half-Life, being a floating skeletal face that fires eyeballs at David.
- Knife - Reskin of the crowbar, found as the first and weakest weapon in the entire game balanced for being extremely fast and rapid.
- P228 - The first firearm that the player obtains.
- Glock - A handgun that deals only 17 damage per shot but has both an automatic and semi-automatic firing mode.
- Revolver - A reskin of the Colt Python, being an incredibly powerful weapon with low and scarce ammo.
- Desert Eagle - The strongest weapon per shot in the game but also the rarest.
- Uzi - The Uzi, like the glock, is weak but has a very destructive automatic firing mode.
- MP5 - A stronger and heftier version of the Uzi.
- Hammer - Can kill a Twitcher in two hits but is a very slow and heavy weapon.
- Axe - Is the strongest melee weapon in the game and is both fast and effective.
- Shotgun - An extremely destructive weapon at close distance that provides a major punch and slow reloading time.