It's not really that hard, unless you play it on hardcoe mode where the environment is constantly sapping your health down. If you have good expertise in either melee/unarmed, guns, or energy weapons, you can make good use of the limited weapons available in DM (you can't bring anything with you into that DLC). Just be conservative of ammo, get as close in as you can to your targets, and use VATS. Open sights and slinging shots all over the place is great when you can run to the store and stock up on ammo again- you can't do that in DM. The most annoying thing to me was the traps- they're all over the place and devilishly concealed in all the spots deliberately engineered to make you miss them or run over them without noticing. I truly detest the devs who were responsible for planting them in DM
That DLC is the one part of New Vegas that actually drove me to choosing the http://fallout.wikia.com/wiki/Light_Step perk on my last char!