I'm more than a little late to the party. Short version is the gaming PC died and I missed out on Fallout 4 when it launched but I've had a chance to enjoy it now long after the wave of hype has subsided.
I gave it a playthrough on normal and found it to be rather easy given my past experience with NV and F3. The only fight that I had to redo a bunch of times was the 1st Mirelurk Queen at fort Independence (I was level 10 and hadn't even gone to Diamond City yet), So I decided to try out survival mode thinking it wouldn't be that big a deal given I'd crushed NV's 'Hardcore Mode' along with some mod I can't recall active that made it a bit more challenging by among other things, adjusting the weight of certain weapons and objects as well as reinstating a lower level cap, diminishing the number of perks you could get.
The hardest parts were at the beginning, I lost count how many times I got killed trying to takedown raiders at the Museum of Freedom, the Satellite Station Olivia or the Corvega Assembly Plant. Even the ferals at the 'Super Duper Mart' proved challenging.
Not being able to fast travel and save whenever I wanted made things a lot tougher. The quest to take Fort Independence in particular. I died twice just trying to get to the rally point even though I was in a full set of T-45. The fight itself was demanding but I was better prepared and placed bottlecap mines appropriately.
Vault 81's mole rat problem was also more challenging given I wasn't going to spend the game with 'Mole Rat Disease' on my character sheet, nor was I going to let the kid die. Tip, close doors behind you as you progress further in to stop them from tunneling to dirt patches behind you and coming at you from multiple directions at once. Use Frag Mines and Molatovs effectively. If there's a known 'emergence point' but no door to close because it's been broken off, that's where you put the mine if you're passing it or throw the Molatov if you're approaching it. There's also a bed in the secret vault that you can sleep in so you don't have to do the Quest in 'one gulp'.
But it got progressively easier at certain points…
The first turning point was gaining access to vertibird grenades. It was certainly faster than walking and gave you a good view of things, also, blowing up abandoned vehicles with the minigun was like Fallout 4's version of popping bubble wrap. It's just a lot more convenient to cross the map in an armed air taxi if a load screen is no longer an option.
The second turning point was having my settlement economy take off having set up mulitple industrial water purifiers in Sanctuary, the Castle (and even Starlight Drive-In). With Charisma, perks, and gear I was selling bottles for 16 caps each and I'd be producing hundreds of bottles a day. With a renewable source of purified water and multiple vendors to turn it into caps I had all the money I needed to purchase things like ammo & fusion cores but also shipments of materials like aluminium, lead, copper, oil etc. This lead to the third turning point…
Power Armor All the Time
Now the restrictions of 'survival mode' seemed like lesser inconveniences. Whereas a bad encounter might have previously resulted in death and the loss of the 'adventuring day's' progress now it just meant having to do repairs more frequently. Eventually I got my hands on a Gauss Rifle and that was it, I could one shot a Death Claw from stealth. Most legendaries could be defeated wtih a crit to the face. With a solid stash of Mirelurk Omelettes I could easily gauss to death in VATS whatever came my way.
Being sneaky was necessary to survive at the start so I would suggest high agility and investing 4/5 ranks into the perk be a priority.
It's a balance between biting off too much or too little. Sleep and save more frequently and you're bound to get sick more often requiring more visits to the doctor or worse, dipping into your stash of antibiotics. Bite off more than you can chew and you'll find yourself repeating the adventuring day (took 4 tries just to rescue Preston & co from the museum, with each failed attemp putting me back at the entrance to Vault 111).
I did a lot of killing outside of VATS (sniping or sneak attacks), thus I don't feel I got as much value from starting the game with 6 points of luck (for Better Criticals). While I certainly made use of VATS, it just wasn't the core of my play style. If I had to do it again, I'd still dump Endurance, but I'd also dump Luck.
Intelligence offers a lot less than in previous games with the absence of skill points. Ultimately this is a positive change because previously I think INT was the overriding attribute that could make a character that had dumped charisma into a great communicator with all of a few levels worth of points into Speech… More XP is nice of course, and surival's 2x XP for slain creatures is doubly so making Int not a stat I'd want to dump by any means.
The perks in the Int tree include a lot of good ones (Medic, Scrapper, Chemist, Science! and Robotics Expert). Being able to make antibiotics is very helpful early on. Being able to build a clinic in a settlement as soon as possible is also a massive convenience. Science! helps with your economy and crafting even if you're not into energy weapons. Scrapper makes enemy arms and armor more valuable as components than vendor trash.
I think Robotics Expert is among the most improved returning perk, especially if you have the Automatron DLC. Not having to be undetected to shut down Robots is huge. Detonating shut down robots to turn them into piles of loot is also nice when Sentry Bots reliably drop two fusion cores among other goodies. A 2nd rank allows for you to modify a robot ally to heal you up out of combat which will substantially reduce your use of Stim packs, food and water for healing as well as the option of flipping the alliegances of whatever Robot you're hacking.
I don't think I'd want to play the game on survival without Charisma 6 for supply lines and shop construction. Shared workshop inventory and shop construction are even more desirable when your carry weight is limited.
Lone Wanderer and just one rank of Attack Dog give you the edge you need early on to deal with multiple armed opponents. The increases to carry weight, damage output & resistance from the former are huge as you rank up. Helping 'crowd control' an enemy or set up an easy headshot while not counting as a companion makes Dogmeat very desirable for a large portion of the game.
Have a nearly or zero-population settlement (Red Rocket is ideal, so is the Mechanist's Lair or even Longfellow's Cabin in Far Harbor) to store your heavy, Area-of-Effect weapons and munitions (Fatman, Missle Launcher). Otherwise, settlers will help themselves when they're under attack whether the weapons are in the workshop or a storage unit like a locker or trunk.
Mirelurk eggs + dirty water = instant AP. There's a number of locales to loot that are rich in empty bottles (Beantown Brewery for one). Fill them up with dirty water and combine with mirelurk eggs (you'll find more along the coast or near water) at the cooking station to make omelettes. They weigh 1/10 of a pound so you can carry a lot. Hotkey them and when you're in a big fight you can instantly regain 50 AP with each tap of the key letting you take more shots in VATS.
Purified water, 'Tatos, Corn and Mutfruit = Adhesive. You need lots of adhesive to craft and modify weapons and armor. Grow those things in your settelments. You'll want some razorgrain to make the brahmin cages. A brahmin adds a unit of fertilizer to the workbench each day and offers some kind of bonus towards food production. Fertilizer is also a key component for manufacturing ammunition if you have that DLC.
Use your stuff. The Flare Gun, the Artillery Grenades and the aforementioned Vertibird Grenades are huge assets. They don't do anything if you don't use them. The Flare Gun summons a bunch of dudes, just what you need early on when you're outnumbered all the time and not packing as much ammo as you would prefer. Having 5 artillery carry out a bombardment on a super mutant camp is fun even if all you're seeing are XP numbers float on your screen. Not every settlement is ideal for artillery duty, some are out of range of the kind of hotspots that would benefit from artillery support (North West quarter). Others are just too cramped. However, given how dangerous the south of the map is, the Castle, Warwick Farm and Sommerville are good settlements to make into batteries. Just be careful if you end up in a 4 way fight between BoS, Raiders, Gunners and Super Mutants as pissing off the providers of your air taxi is not a good outcome from calling in a strike…
Eschew automatic weapons. This is a style preference, I recognize that but I think the economics are sound. They consume more ammo and the other weapon perks have more to offer than 'chance to stagger'. In normal mode, ammo has no weight value and it would be a competitive option. However, in survival the ammo does weigh something and having less of it means more room for loot.
You can't rescue every settlement calling for help but you should definitely rescue the ones that are major production centers. Be proactive about defense by building as many of the best turrets you can. I took this to the extreme at the Castle with multiple Heavy laser and Missle Turrets. I needed high DEF values to offset the 200+ water production. However, the quest 'Defending the Castle' was kinda funny as the Institute's minions were all but instantly obliterated each time they tried to approach rather than beam in directly and those that did beam in got wasted in short order by the inhabitants which included about 1/5th of them being heavily armed and or armored companion NPCs…
The minute men offer the cleanest route to victory over the Institute. No beef with anybody or tech-fetching to build a giant superbot, just 'here's a password and a computer program to upload, now go through this water pipe, don't get lost and we'll see you on the other side'. They could have called the Quest 'Nuclear Option: Megaton II, Megatonnyier nuclear bugaloo' given you detonate the win-bomb from atop one of the tallest structures on the map to watch the fireworks.
I wouldn't say I advise it but I never invested any ranks into lockpicking or hacking in any of my playthroughs thus far. The game design never places objectives behind gates that depend on specific perks to overcome. I think the issue is that here the change away from skill points is most acutely felt. A highly intelligent character with the educated perk could take a character that started with about 25 or so points in either to the max in 5 or so levels. Whereas the level pre-requisites for additional ranks to imrpove the class of lock or computer that you can get through make the perk less interesting (to me) than other options (more Charisma or Cap Collector perks) to gain access to more wealth. I might feel differently about that if I was more familiar with the game and knew where the equivalent of the Gobi Campaign Sniper Rifle from NV was locked up behind a 'Very Hard' lock in a location not terribly difficult to reach.
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