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Sex & Nudity
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- A painting in Chapter 6 has a nude woman. Her breast and nipple is visible, along with her side buttock and thighs, but not in a sexual manner
Violence & Gore
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- The game begins with a scene of death and destruction involving dead animals and people strewn everywhere. A police officer is killed by a shrouded figure.
- Upon arriving at Darkwater, the game's main location, a dead and bloodied orca is seen lying dead on the land.
- A doctor is shown performing an operation on a figure. The protagonist stops him but sees the patient is dead. He interrogates the doctor but then the mangled corpse of a patient attacks the protagonist.
- The player can choose to make the protagonist beat several people to death in the game's climax.
Profanity
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- Depending upon whom the main character talks with, words like "Damn" or "Fuck" can be heard,
Alcohol, Drugs & Smoking
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- The lead character which players will role play is a struggling alcoholic who has a reputation for his condition and is confronted for it by many people he comes across.
- The main character can choose to go to a tavern while consorting with characters.
- The player can choose to talk with people who drink and/or smoke at the tavern.
- The main character can choose to say, "Prohibition is just a joke around here. That suits me fine."
- The main character can choose to interview several people who happen to be drunk. Some of their dialogue is quite crude.
Frightening & Intense Scenes
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- The entire game has a dark, foreboding atmosphere, and follows a depressed man through mysteries of paganism, rituals, insanity, and a hellish world in which he slowly but surely loses his sanity.