I'm just about to finish the final quest with my first character (well, 2nd but the first only lasted about 3 hrs and only just finished When Freedom Calls). This has been my Do-Everything character that I always start with in these kinds of games, so I've seen a good portion of what the Commonwealth has to offer.
As I contemplate my first Replay, I'm thinking about trying to limit myself to a single death. That is, like hardcoe in Minecraft, dead is dead and saves are only for quitting for the night. I would probably play at Normal or Very Hard difficulty as I find Survival's bullet sponges a bit off-putting, and I think its reduced healing might just make the game unplayable if I enforce the Single Death rule. I would probably also run the Storms and Darker Nights mods to enhance realism a bit, as well. The mod to make weapons more deadly might work as well, but I'm concerned it might make the Sole Survivor into Kenny a bit too easily.
My goal with this playstyle would be to increase the sense of danger and consequence. Don't power through that iffy encounter and count on restoring a save if you fail, run away and come back when you're more confident or better equipped. Don't horde stimpacks and food for a never-realized "rainy day" (because when it pours, you re-load) but make sure to keep that health high at all costs! I would off-set this vulnerability at beginning stages a bit by using console to add a combat rifle or hunting rifle and limited ammo at the SS house in Sanctuary, with appropriate RP explanation based on character build - hunter or survivalist with a gun stashed in the house before the War. I might even add a free perk in Rifleman, I don't know.
What do you think? Has anybody else done a Single Death playthrough? Anybody see any considerations that I might have missed? My one big hesitation is that this setup practically demands a cautious, stealthy play style to ensure survivability and I've basically just done that with my Prime character.