Expand the use of Pills by adding a "Panic" state that causes visual distortions or erratic movement if the player's anxiety meter stays high for too long.
If you are developing a mod or a standalone addition, you can find more inspiration for level design and entity behavior on the Backrooms Wiki . Inside the Backrooms on Steam
Introduce subtle environmental changes (e.g., doors appearing/disappearing, wallpaper changing color) that only one player in a co-op session can see to increase paranoia.
Create randomized "glitch spots" in the walls that require a specific sequence of actions to trigger, acting as a shortcut or an alternate ending path. Entity & Interaction Features
Allow players to "Barricade" certain doors temporarily using found items, providing a brief window of safety from chasing entities like the Howler .