As you explore the treacherous wastelands of Ohio. You have many encounters with mobs that are absolutely terrifying, while you have to worry about your sanity. In forests you'll find eyes, creepy unnerving eyes from the Eyes in the Darkness mod, this makes an awesome combination with the Hardcore Darkness mod. With the Hardcore Darkness mod makes a terrifying duo with the Doctor Who's Weeping Angels mod so be careful. Be aware as you may find yourself in the Backrooms...
Optifine is not needed but highly recommended.