You could always try a Dad is Dead playthrough. It adds a extra bot of tension to a playthrough. There has been threads over at another Forum I frequent that has a list of graves with names stats and time of death. Alongside other gamers and their progress. So it can get a little competitive as your always trying to beat your last run and the best of others.
Just one rule...Dead is Dead.
1) When your character falls in battle or falls from a cliff, that's it. They are dead. Game over. No reloads. Feel free to restart, ( at the cave exit ) with the ole "I or II", after their names. If you so choose.
...If your character falls due to a glitch, the game locks up or due to any outside action and/or distraction ( kids / pets / mother-in-law ) at no fault from the player. No shame will fall upon you to revert to a previous save.
NOTE : Difficulty has no bearing in DID. It should be set, according the comfort of the player. Pending things like character build, roleplay, limits, mods, and experience, this can easily vary among players.
Check out my Fallout Alaska Fan Lore Master Thread 2, pop in, leave a suggestion, or simply comment. Why is it called a Master Thread? Well because it's where all my updates will go first.
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Updated regularly. It's about Alaska and the Wackiness that ensues therein.