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- Judd Birch is walking Nightmare Fuel, being a stereotypical emo teenager and Straw Nihilist that busies himself with training raccoons, committing acts of vandalism and writing a "manifesto." Even the way he cuts and eats his food is reminiscent of stabbing.
- Marty Glouberman, Andrew's overbearing Borscht Belt father. Though Played for Laughs in his every appearance, he's very verbally abusive of Andrew, castigating him for every mistake or problem - including those that he could not have possibly had a hand in.
- While often played for laughs, Jay's home situation is a nightmare. His alcoholic, neglectful mother has to be reminded of his name and existence, and his father is an amoral, misogynistic attorney that doesn't let legal ethics or even his disbarment get in the way of winning a case. His older brothers, Val and Kurt are the worst, however. They are homophobic, sexist bullies that emotionally and physically abuse Jay for a cheap laugh, even going as far as to force him to eat their bodily fluids. It's almost a relief that Jay is a Loveable Sex Maniac and not a Serial Killer. Speaking of which...
- The Ponytail Killer. As of season 5, nobody knows who he is or why he targets people with ponytails. Only a scant few clues to his identity are given throughout the show and none of them lead anywhere.
- Though he always comes across as happy to be alive, Coach Steve has hinted at having a very Dark and Troubled Past on numerous occasions. When he was a child, his adult friend Gary shot himself in the mouth while they were both in the same car, his stunted mental growth has made him the victim of various crimes that include organ theft and he has been fired from multiple jobs for one reason or another. At one point, he even casually mentions that he has contemplated suicide.
- Mr. Lizer faux-flirting with Jessi when she comes to school in a red bra. This short, sweet and to-the-point exchange is the first sign that his intentions may not be as noble as he presents them.
- The Reveal that Daniel is a serial "head-pusher" with no respect for sexual consent in spite of his thespian persona. While his comeuppance is more than well-deserved, his actions are a disturbingly real reminder of a very real problem.
- Maury decapitating and "skull-intercoursing" Garrison Keillor.
- The sleepover episode is pure terror, with Lola and Devon exploiting Missie's sugar rush for shits and giggles while Jay's sociopathic older brothers make Andrew and Nick fight for their amusement. And that's before Val and Kurt try to make them eat cum crackers.
- Andrew's nightmare after promising to never masturbate again, which has the school gymnasium descending into anarchy while it crumbles apart beneath his feet. As Nick Birch, dressed like a priest, gives a fire-and-brimstone sermon about the futility of holding back one's urges as a giant Maury rises behind him speaking with him in unison.
- Judd is able to freely travel throughout the Birch household and spy on others without their knowing, implying that he hollowed out the entire house. His most obvious modification to the building is also his most disturbing: his bedroom door. Which reads, in scrawled-out letters, "Trespassers will be flayed!"
- The POV of the Ponytail Killer as seen from the bushes, spying on Jessi as she opens up to Jay about her homelife. His interest in her fades when she lets her hair down, only to settle for another target that walks by none-the-wiser.
- Jay and Jessi discovering one of the Ponytail Killer's victims in the synagogue dumpster.
- Just when Andrew is able to overcome his pornography addiction, a SWAT team bursts into his room and arrests him at gunpoint after a botched DNA test frames him as the Ponytail Killer, throwing him into an adult prison. He's bailed out by Jay's father...only to find that the synagogue's security cameras caught him throwing his defiled socks in the dumpster and the footage has made him an internet laughingstock.
- The Shame Wizard may have some humorous moments, but when he's putting his sinister plans in motion he's a legitimate Knight of Cerebus. Not only do his appearance and actions have a naturally villainous tone, but the way he creeps around kids and gives them no privacy has a definite pedophile vibe. He's also got a wicked Game Face.
- He terrorises Andrew when he's caught masturbating over Leah's swimsuit, then subjects him to a kangaroo court where Maurice has little power. The episode ends with him winning as both Andrew and Maurice masturbate in a fit of self-loathing.
- When he brings the shame during his musical number, he multiplies, flies around the school spreading a dark fog that kills joy and all of his duplicates converge and form a gigantic version of himself.
- And just like the Hormone Monsters, he's completely immortal and any attempt to stop him can only be temporary.
- It's a little disturbing to see easy-going Nick try to kill poor, well-intentioned guileless Rick at the urging of his remaining pube. As noted in Narm Charm, it's oddly sinister to hear good ol' Jack McBrayer goad Nick into attempted murder. Thank God he didn't go through with it.
- Coach Steve losing his virginity to Jay's mother. While he's glad to finally have sex with a woman, Jenna's advances can only be described as predatory and Steve is described by doctors as a "manbaby." Put two and two together.Matthew: I think whoever had sex with you may have committed a crime.
- One segment from "Planned Parenthood" called "Blue Waffle" plays like David Cronenberg lit a film with a black light. The whole bit is in black and white, save for the blood and gore, which is an unnatural shade of blue.
Duke: Get out!
- It's rectified in the end when the nurse at Planned Parenthood reassures Andrew that Blue Waffle isn't a real STD, so he has nothing to worry about. Then she turns into Slenderman.
- An especially creepy part is when Andrew runs to Nick's house, where both Nick and Jessi act disturbingly calm and normal about everything, and Duke is there as well, with a single drop of blue dripping from his nose. There's also the terror in his voice as Duke tells Andrew to run.
- Marty becoming infected by Blue Waffle like a zombie virus, and blows Missy apart with a shotgun, before going after Andrew himself.
- Greg's terrifying roommate at Guy Town: a portly, demanding shut-in with a failed "religious dog-wig" business who hits on Jessi in front of her father when she comes to visit. An outraged Greg finally decides to stand up for himself and his daughter, moving himself out of Guy Town...and into Coach Steve's shipping container.
- The roommate's distinctive hairstyle and criminally inappropriate behavior has convinced many fans that he is in fact the Ponytail Killer.
- Nick gets high off of THC-laced Gummi Bears with Jessi and his trip starts to take a turn for the worse, where he sees his future self as a game show host in what looks like the burned-out remains of Hollywood. "Nick Starr" cheerfully tells Nick Birch that he's going to be starved of any and all forms of human relationship in spite of his future fame and fortune. Even after this horrible trip, Nick is filled with so much anxiety that he's convinced he's about to die and runs to the hospital. Fortunately, Judd is able to drive him home to bed to recover. Unfortunately, he also uses him as bait for his army of trained raccoons.
Judd: Hey boys - he's the garbage! (turns out the light, leaving Nick alone with his "army.")
- The Depression Kitty is very unsettling, due to Jean Smart's disarming, Southern-tinted voice carrying just the right hint of sinister undertones. Kitty acts benevolent at first but slowly smothers Jessi until she can't move. When she brings Jessi into a padded room, the door disappears.
- Even though Jessi gets rid of her, the Depression Kitty reappears several times in Season 3 and Season 4, showing a saddening, yet realistic effect of depression that for many people, depression is a lifelong battle, regardless of the amount of therapy or counseling. In fact, the pressure Kitty puts on Jessi, a seventh grader causes her to not want to leave her bed in the morning for school or talk to anybody.
- Andrew's descent into toxic masculinity at the end of "My Furry Valentine." Anvilicious as it may be, it ultimately shows just how dangerous someone can be when they don't recognize their own possessive tendencies, and how quickly it can turn an otherwise reasonable person into a monster.
- Andrew attends an open meeting for men that are sick of being rejected by women, only to realize that they are not only deeply misogynistic, but full-blown white supremacists. Andrew, being Jewish, is quick to read the room and leave the meeting, ignoring Maury's suggestion of burning the place down, Inglorious Basterds style.
- Nick's mother gets uncharacteristically vicious when Nick spends too much time on his phone. When she's finally had enough, she takes his phone and impales it with a fire iron.
- Jay sinks to new lows when he decides to sell adderall to students as study aids, becoming a full-blown drug dealer.
- Missy's brain under the effects of adderall. It's pretty much like being at a rave when you've got a headache.
- Mr. Lizer tricks Lola into giving him a foot massage, then gaslights her when she gets suspicious, in a disturbing representation of child grooming.
- When Jay and Lola decide to make their own pool behind Jay's house, they find a pair of skeletons hugging each other buried there.
- The Nightmare Sequence Tito causes Nick in "Poop Madness" with Tito whispering how Nick will be bullied and forgotten by all of his friends due to being given the embarrassing nickname of Soup, dropping a locker with the word Soup written in what appears to be blood in front of him while showing Andrew, Missy, Jay and Jessi pointing and laughing at Nick with glowing yellow eyes. Then Tito tells Nick he'll die a sad old virgin which causes Nick to rapidly age with the skin melting off of his body until he turns into a skeleton. For the cherry on top, a horde of Anxiety Mosquitos swarm Nick and form into Andrew's face who tells Nick how horrible of a person he is. Meanwhile, Nick is hyperventilating and genuinely looks like he's about to cry. It's a very accurate portrayal of how a panic attack can burrow into your brain and make you feel like the world is closing in on you.
Andrew: This is fucked up! This is beyond the pale!
- The "Poop Madness" song and Disney Acid Sequence. Strange rabbits, deer made out of poop, buttholes, and an anthropomorphic pig or warthog with an elephant's trunk for a penis.
- The entirety of "Nick Starr", being a look 32 years (at the time of the episode's premiere on December 4, 2020) into the future which portrays a Crapsack World with the ozone layer completely gone and the world on the brink of extinction from global warming. There is a class disparity with Nick's future self Nick Starr; a Jerkass game show host who has citizens compete in sadistic games in order to receive basic human needs like food and water, living in an idyllic penthouse in the clouds, having nobody but a robot butler version of Andrew for company, while the world under the cloud line has fallen into complete Mad Max-like chaos with Lola and Jay leading a sex cult in Nick's childhood house and turning his parents into sex slaves, Missy being the ambassador of Earth and tragically dying in a flying car accident, and Jessi turning into a punk rebel who fights against the corporations ruling over the lower class, even showing her donning a suicide vest. Fortunately, by the end it is all revealed to be a nightmare Nick was having... although the persona of Nick Starr ends up being very real.
- Milla and Lotte take a selfie at the 9/11 Museum, which reveals them to have sharp teeth, claws and snakelike eyes. They then talk directly to the audience, taunting them about how they can't save their favourite characters from being eaten by them.
- "Horrority House": After getting drugged, the characters all have gruesome horror-movie-like nightmares based on their anxieties, creating some of the most chilling scenes in the show.
- Jessi finds herself trapped in a mental institution stuck in a straitjacket, with her therapist calmly reassuring her that she belongs there now. Not only is it Realism-Induced Horror for those struggling with mental health issues, but her therapist's head bends and rotates in creepy positions and her eyes roll back into her head by the end. It's quite eerie.
- Missy's identity crisis is represented by her seeing visions of herself in several mirrors. Mirror Missy from Season 2 shows up to warn Missy, but her throat gets bloodily slit with a pair of scissors. Another Missy rises up behind her, revealing it to be Missy's abandoned overalls. Overalls-Missy's face has a lifeless expression, complete with dead eyes and a creepy Slasher Smile, while her overalls threaten her that "there can only be one" with the same sickeningly childlike voice they had earlier in the season. This later leads to a bloody battle between the Missies, who keep repeating, "There can only be one!"
- Matthew's nightmare consists of a Sadistic Choice where his mother and Aiden are both tied up over a rotating saw, and Matthew has to choose which one to sacrifice, symbolizing his internal conflict between his family obligations and his sexual orientation. When he dithers for too long, more of their bodies get bloodily chopped off. It does become less scary at the end of the scene, when Matthew notices how dumb it is that they continue to argue even when they're just severed heads and realizes nobody's going to die no matter which life he chooses, but the relatable tension coupled with the blood is still disturbing.
- Andrew imagines his father has a heart attack and gets into a car accident that kills him, and then Andrew contracts a flesh-eating virus that suddenly causes all his skin to wither away, leaving him as a skull and bones. Then Andrew is on a plane with a hole in the window and he plugs up the hole with his butt, and the immense pressure causes his entrails to be pulled out of his sphincter alongside his reproductive organs. It's alarmingly realistic for a cartoon.
- A clown hunting Nick down isn't as chilling as the other examples, as it's more or less a straight horror parody. Once said clown is revealed to be Nick Starr, however, it gets chilling. Specifically near the end, when Starr stabs Nick in the chest with no shame, the screen shifts to a haunting red tint, and Starr coldly tells Nick to never get close to anybody.
- The end of the episode, where a whole swarm of anxiety mosquitos burst out of the murder house, laughing maniacally. It's a sudden Jump Scare, and the implications that the entire town is going to have nightmares like this makes the viewer fear for the next episode...
- The three-headed monstrous version of Tito in Nick Starr's mental realm, which introduces herself with an ear-piercing shriek and speaks in unison in an unsettling mechanical way. But it's a bit Nightmare Retardant when its first dialogue is threatening Nick with the unavoidable fate of putting yellow mustard on everything.
- "The Shane Lizard Rises":
- Missy has a nightmare sequence, induced by the Shame Wizard, where she and Devon are trapped on a moon covered in her back acne. The pus is so acidic that it burns off Devon's legs and lower body, and we see his stringed muscles and a trail of blood as he painfully tries to escape to Earth.
- Jessi tries shaving for the first time with an old razor. She nicks herself so badly that her legs ooze rivers of blood. Doubly cringe-inducing if you've struggled with shaving cuts before.
- Near the end of "The Green-Eyed Monster," Walter stabs himself because Nick's love for Jessi is unrequited. Then Rick swallows soda and pop rocks and explodes a hole through his stomach, exposing his guts.
- The nightmare sequence Jessi has in "Thanksgiving," where she envisions her future half-sibling as a monstrous "Cheese Baby" climbing on the walls, biting with razor-sharp cracker teeth, and speaking in a creepy crackly voice.
- Rochelle's transformation into a Lovebug. She screams in pain and her body hideously cracks open, making you believe she's dying. Luckily her Lovebug form is so beautiful.
- In the Christmas Episode, The Jansen Twins tell the story of Vader Johan (Father Johan), a terrifying Eldritch Abomination that makes The Krampus look like the goddamned Easter Bunny. Described as a mix of a walrus, a dolphin and "the legs of countless crabs", he lives on the bottom of the ocean in a castle made of childrens bones, and appears on Christmas Eve, playing a flute also made from childrens bones, searching for fresh victims. And it doesn't matter if you've been good or bad, Johan will come for you anyway. Your only chance at escaping him is by sleeping inside a child's coffin, making him think you're already dead, but if he hears your blood, he can tell that you're still alive.
Once You've Heard The Story Of Vader JohanYou Must Share The Story of Vader JohanOr You'll Be Consumed By Vader JohanWhich Is Like Death, but Worse!
- There's a slightly silly part of the story about how Johan's good counterpart is the Mongoose King, who will appear if you put painted eggs in the window, and engage the monster in a dance-off to drive him off, but whatever Nightmare Retardant this might offer is short lived, as this isn't a guaranteed win! If the Mongoose King loses, Vader Johan gets a fresh victim. Oh, and according to the Jansens, death won't be swift, you'll still be alive inside Vader Johan to digest eternally. And finally, if you've once heard the story of Vader Johan, you must spread the story yourself, or he'll come for you next!
- Jessi develops a horrible yeast infection in "Vagina Shame," which is Nausea Fuel in itself as we see close-ups of her infected anthropomorphic vagina. Then her vagina gets overtaken by its evil twin Beatrice, turning into a screaming fanged mess on top of being extremely red and leaking pus.
- "Mario", the unhinged commuter that takes an interest in Andrew while he travels to Vermont by himself. He tricks Andrew into accepting a lift in his car, which he later admits was stolen. Then a highway patrolman pulls them over and "Mario" goes apeshit.
- It's brief but we're given this exchange from the climax of "Asexual Healing" that, when compared to a lot of the degenerate things the hormone monsters have said prior, feels genuinely cold and disturbing:Connie: Oh sweetie, humans change slowly. Ya gotta give em' time.Montel: But I thought you said they'd all be dead in 10 years.Connie: Ssshhh… baby, they don’t know that yet.
- During the climax to "F**ked up Friday", Andrew in Marty's body finds himself suckered into having sex with his own mother. He's visibly panicked and Maury is deliberately not helping because he lives for this kind of sick shit.