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You control an unnamed protagonist referred to simply as "You"; as its title implies, the aim of the game is to survive a zombie(?) apocalypse set After the End by scavenging food and items, while attempting to find a way out of the city in which you are trapped.
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- Badass Grandpa: The Director, who's at least middle-aged and routinely goes scavenging in the monster-ravaged wasteland for goodies.
- Big Bad: The closest thing to one is the Man in Blue, who tempts and taunts You into staying trapped in his delusions. He supplies You with extra ammo, encouraging aggression and destructive behavior.
- Big Good: The closest thing to one is the Man Who Wears a Box. He supplies You with food and batteries, encouraging pacifism and healthy behavior.
- Bland-Name Product: The GameJoy. The red-and-white soda can labeled 'soda'. The ground meat which is apparently called "SPUM".
- Body Horror: The two types of monsters seem to be formerly humans, faceless and mutated.
- Broken Bridge: The city and apartments would be a lot easier to navigate if these weren't all over the place.
- Companion Cube: The Cat Plush and Chuck the Plant.
- Cryptic Conversation: Expect a lot of this. The Director and Hank are the only ones who really bother to speak plainly.
- Driven to Madness: Occurs gradually to the protagonist (maybe), as well as Hank if he is given enough blue pills.
- Foreshadowing: The Man With a Pale Face is the main representative of the Green ending, which shows the Lone Survivor the truth he's been trying to avoid. For that reason, the Survivor feels deeply uncomfortable whenever he draws near the pale-faced man.
- Gainax Ending: In multiple variations.
- It May Help You on Your Quest: Several items are provided by other characters, such as the flashlight, the gun, and cooking supplies.
- Last Lousy Point: Attempts to obtain a more preferable ending are bound to be dogged by this.
- Loners Are Freaks: Averted by The Man With a Box on His Head. He's a bit of a weirdo and tries to convince the Survivor that isolation prevents you from being hurt, but is ultimately one of the more benevolent characters.
- Luke, I Am Your Father: A radio snippet right at the game's end suggests that this may be the case for You and the Director.
- Multiple Endings: The ending that occurs is based on numerous acts performed in the game. These statistics are listed as a "psych report" after the ending is shown.
- No Name Given: Most characters have either vague names (You and She), descriptive ones (The Man With a Pale Face, the Director), or actual ones (Hank and Chihiro), but the Man in Blue's title is only shown in the postgame; otherwise, his name shows up as "???," even though he constantly insists that You knows him. This might be because he's actually a hostile figment of You's imagination. If You acknowledges that he's real, it earns a ton of points towards the Blue ending.
- No Peripheral Vision: Some rooms have alcoves that "You" can press against to hide from and sneak past monsters.
- The Plague: The monsters are created this way. Hank has been infected, and is slowly turning into one himself.
- Retraux: Everything is done in a highly pixelated style.
- Sanity Meter: Albeit an unseen one that affects which ending you get. Several factors raise or lower your sanity, including monsters killed, types of foods/pills consumed, sleep schedule, and the completion of optional sidequests.
- Attempting to eat Rotten Meat acts as a visible indicator of You's sanity. If You's mental health is fine, You will just say "No." If it's deteriorating, "Maybe." If you've been neglecting it a lot, "Actually, that looks pretty tasty."
- Surreal Horror: What isn't symbolic is likelier just nonsensical, but often used to disturbing effect.
- Survival Horror: This is the game's core mechanic, emphasizing resource management and difficult pick-your-battles scenarios.
- Survivor Guilt: Arguably the driving theme of the game's plot. The Lone Survivor was in all likelihood the only one who lived through the bus bombing, and the events of the game itself are just an extended delusion to help him cope. The ending you get determines if he sinks further into psychosis, kills himself, or heals and moves on.
- Trademark Favorite Food: You has generally positive opinions on most of the things he eats, but cooked ham practically sends him into spasms of joy. Even the psych report listing for how many times you've eaten the dish just says "BAKED HAM!"
- Weapon of Choice: The protagonist comes to a gun shop filled with automatic weaponry and even (somewhat inexplicably) a chainsaw. His statement that his pistol is more "his style" prohibits the player from picking up any of it.