Larger mods, such as SacrificialMods' , are often used in conjunction with self-harm traits to create a complete "dark" narrative. This mod includes interactions like "Stab Guts," "Shoot Sim," and allows for suicide outcomes. It also features a reputation system and is often paired with the "Broken Heart" trait to enable a suicide-by-sadness narrative.

: While "Extreme Violence" mods exist and are often discussed in the community, the Sims team distinguishes between stylized game violence and "deeply disturbing" content that violates safety policies. Safety and Security Risks

Navigating the Controversy and Realism of Mental Health and Self-Harm Mods in The Sims 4

Some complex "Mental Health" or "Life Tragedy" mod creators (like Sacrificial KawaiiStacie