- The entire setting of The Spanish Flu and aftermath of World War 1 is a nightmare one. There's mass graves, abandoned buildings, people who committed suicide after their loved ones died, and a sense of all consuming despair. This is before you mention the fact the streets are full of free-roaming hungry vampires and religious fanatics.
- Jonathan waking up as a vampire and the discovery his first (and possibly only) victim is actually his own sister, Mary, who braved the worst parts of London to find his body for a proper burial.
- Jonathan is so overwhelmed by this, he ends up Driven to Suicide. It doesn't take because he uses a gun.
- The discovery of Mary's backstory. Not only was she turned into a vampire and abandoned by her brother but she lost her son and husband due the Spanish Flu as well as World War 1. The betrayal of her brother and transformation into a vampire is what leads to her HeelFace Turn and Sanity Slippage.
- The entire encounter in the cemetery where Mary may or may not murder her own mother before Jonathan's eyes. She is a Death Seeker and wants Jonathan to kill her or to kill Jonathan. Only when he beats her and is willing to euthanize her is she willing to forgive him.
- Carina Billow used to be a woman's suffrage supporter alongside Charlotte, until she barked at the misogynistic Ascalon Club, which promptly mind-raped her into insanity and turned her into their rat-eating slave. In-game, the only thing you can do for her is give her a Mercy Kill.
- Doris Fletcher and her final moments are similarly tragic. She puts on a final dramatic act as the disease has tarnished her beauty and ruined her acting career. The Last Request she asks of Jonathan is to make sure someone remembers her before she self-immolates.Doris Fletcher: Thank you... and farewell...
- Geoffrey McCullum if he becomes a vampire, relates his backstory. He explains that his mother was murdered by his father when he was turned into a vampire. The fact he has not become a monster has clearly made him reflect on things.
- Almost all of the minor NPCs have tragic backstories of one sort or another.
- Milton explains why he's The Cynic and it's basically just a long list of the horrifying things he's seen as a WW 1 era EMT. These include horrific crimes, child abuse, and apathy. This is before the fact he's a black man in a relationship with a white woman in 1918 England with the dual problems of WW 1 and the Spanish Flu. Oh and vampires.
- Mortimer Goswick is a suicidally depressed young man who may or may not be suffering from clinical depression or just living in a Crapsack World. His mother is utterly helpless to do anything about it and while she's not the most personable sort, her love for her son is real as is her wish she could do anything to prevent it. If you kill Mortimer, he also realizes he wants to live with his last thoughts.
- Stella Fishburn is a kindly old lady who just happens to have a Serial Killer for a son. She has a Hope Spot moment when Doctor Reid comes to her. She asks if it's possible for her son to be institutionalized. Reid is then forced to break it to her that while her son is mentally ill, he's perfectly aware of his actions being wrong despite not caring and thus not legally insane.
- Lady Ashbury has a Heroic BSoD when she discovers it was her blood which allowed the Red Queen to possess Harriet Jones and make her a Disaster.
Tear Jerker / Vampyr