| Achievement | How to unlock
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| - Use a first-aid kit 100 times in Challenge mode.
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- Almost there (200 points)
| - Exit the fourth zone in Challenge mode.
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- Anomaly hunter (200 points)
| - Use the trap to destroy the electrical anomaly in Challenge mode.
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- Attacks of aggression (200 points)
| - Acquire "Attacks of aggression" madness for the first time in Challenge mode.
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| - Cook food in the oven in Challenge mode 20 times.
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| - Break 50 doors in Challenge mode.
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- Burst of anger (0 points)
| - Acquire "Burst of anger" madness for the first time in Challenge mode.
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| - Complete any 25 repairs in Challenge mode.
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| - Eat 50 coffee beans in Challenge mode.
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| - Find every tool in the game.
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- Color blindness (0 points)
| - Acquire "Color blindness" madness for the first time in Challenge mode.
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- Crazy laughter (0 points)
| - Acquire "Crazy laughter" madness for the first time in Challenge mode.
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- Doubtful utility (0 points)
| - Acquire "Doubtful utility" madness for the first time in Challenge mode.
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| - Earn the second bad ending in Challenge mode.
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| - Add fuel to furnaces 50 times in Challenge mode.
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| - Turn mad for the first time in Challenge mode.
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| - Exit the first zone in Challenge mode.
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| - Fire a gun 20 times in Challenge mode.
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| - Acquire "Gluttony" madness for the first time in Challenge mode.
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- Hallucinations (0 points)
| - Acquire "Hallucinations" madness for the first time in Challenge mode.
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- Handle with care (0 points)
| - Finish four zones in a row without breaking a single door in Challenge mode.
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- Heartless behavior (0 points)
| - Leave a living character behind when proceeding to the next zone in Challenge mode.
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| - Earn the first bad ending in Challenge mode.
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| - Acquire "Homesick" madness for the first time in Challenge mode.
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| - Acquire "Hyperopia" madness for the first time in Challenge mode.
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| - Complete the game with three characters in Challenge mode.
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| - Don't sleep in the first zone in Challenge mode.
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- Intolerable hunger (0 points)
| - Acquire "Intolerable hunger" madness for the first time in Challenge mode.
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| - Exit the fifth zone in Challenge mode.
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- Last man standing (0 points)
| - End the game in Challenge mode with one survivor.
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| - Exit the third zone in Challenge mode.
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| - Saw up nine crates during a single game in Challenge mode.
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- My poor lungs! (0 points)
| - Smoke 10 cigarettes during a single game in Challenge mode.
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| - Acquire "Myopia" madness for the first time in Challenge mode.
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| - Acquire "Night vision" madness for the first time in Challenge mode.
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- Obsessive singing (0 points)
| - Acquire "Obsessive singing" madness for the first time in Challenge mode.
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- Occult enlightenment (0 points)
| - Acquire "Occult enlightenment" madness for the first time in Challenge mode.
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- Overloaded reflector (0 points)
| - Earn the secret ending available in Challenge mode.
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| - Resuscitate a character 30 times in Challenge mode.
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- Repairs needed! (0 points)
| - Break six objects while under the influence of the "Burst of anger" madness.
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| - Cook every kind of food in the oven during a single game.
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| - Earn the good ending in Challenge mode.
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- Shakespearean expert (0 points)
| - Acquire "Shakespearean expert" madness for the first time in Challenge mode.
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- Space distortion (0 points)
| - Acquire "Space distortion" madness for the first time in Challenge mode.
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- Strange whisper (0 points)
| - Acquire "Strange whisper" madness for the first time in Challenge mode.
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| - Find and save the third character on the base in Challenge mode.
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| - Turn on generators 100 times in Challenge mode.
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- This is the end! (0 points)
| - Complete the game with any ending.
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| - Acquire "Too much" madness for the first time in Challenge mode.
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- Two doors behind (0 points)
| - Exit the second zone in Challenge mode.
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| - Charge the reflector once in Challenge mode.
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| - Acquire "White noise" madness for the first time in Challenge mode.
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