As you open the door the noise breaks the silence – a white noise, menacingly pulsing as you slowly edge down the corridor. It means there’s a monster up ahead and as you approach it, the noise grows louder as your heart beats faster. Then it’s in front of you, tall and pale, its featureless head twitching back and forth aimlessly.

You have three options: shoot it and use some precious ammunition, but you’re running a little low already; find your way around it, maybe using rotting meat to draw it away; or you can turn off the game and try to sleep, emphasis on try.

The roaring white noise batters your ears as you struggle to come to a decision.

After a little while as the lone survivor, this is a familiar situation. The atmosphere is oppressive in every way. The darkness of the aesthetic, the loud, unsettling noises of the game’s sound design, and the overall feeling of vulnerability are all unrelenting throughout. Lone Survivor is a true survival horror, it’s gritty, filled with gore and disturbing, but most of all it ensures that you are vulnerable at all times. It is perhaps unexpected that all of this terror comes in the form of a pixel-style side scroller.

Before you start the game, it tells you that you should play in the dark and with headphones, or at least with the sound turned way up. If you’re feeling particularly masochistic you should definitely go with headphones, but the dark room is almost essential as if you’re in a bright environment you’re probably going to have difficulty playing at all. Even with the little sunlight that made its way through the gap in my living room curtains the game was impossible to play – not dark like it’s supposed to be, but too dark to see at all even with my Vita’s screen brightness up as high as it would go.

So, it’s unlikely that you’ll manage to play Lone Survivor outside without difficulty, but then again if you want the experience the way it is supposed to be, you’ll be alone in bed with the lights off and headphones in.

It begins with a few dream sequences that set the tone. Misdirection and mystery are both worn on its sleeve as it makes use of both right from the very beginning, with things appearing behind you when there was previously nothing there and the constant feeling that even ignoring the obvious disturbing setting and aesthetic, something isn’t quite right. The true masterstroke that makes Lone Survivor so damn good is not in its visual aesthetic or even its superb sound design, it’s in how it fills you with doubt from the very beginning.

Your character, referred to simply as “You” throughout, is unsettling all on his own. The surgical mask that covers most of his face looks like an unnervingly wide grin, and sometimes strange things happen that don’t necessarily seem to make too much sense even in context. And then there are the dreams, weird ones that you wake up from with new items somehow, with strange people who You say seem familiar. The game constantly hints that something is wrong with not only your situation, not only your surroundings, but with You.

That is where things go a little awry, however. The game hints at many things but it doesn’t always fully explain everything, and whilst leaving some things to interpretation is a good thing Lone Survivor might have benefited from being a little clearer a little more often. Even further, the actual mechanics of the game, such as drawing monsters away from their haunts by dropping some rotting flesh (taken from the fridge in your apartment, which acts as a safe home base) and hiding in the background as they pass, or eating and sleeping whenever You mention it a little too often, grow a little dull as you progress further.

This leaves behind the oppressive, dark atmosphere that could leave you without a desire to return to the game if the terror or survival horror isn’t necessarily your favourite thing. The intrigue regarding why things feel a little off might keep you coming back, however, and exactly what that thing is can change depending on your decisions throughout.

As is implied by the “Director’s Cut” tagged onto the title, this edition of Lone Survivor comes with additional content over the game’s release on PC last year. The content comes in the form of additional items, locations, dialogue, music and even new endings available in New Game + to name just a few. It’s clear that Jasper Byrne (original creator) and Curve Studios (the developer that worked with him on the port) went all out in not just porting the game to PlayStation systems, but improving it and adding to it. The game is really a labour of love on Jasper Byrne’s part and Curve were happy to accommodate his finickiest of requests.

Taking the graphical fidelity of older generations of games isn’t where Lone Survivor stops when it comes to its influences, with bits taken from the likes of Silent Hill and other classic horror games, it combines them with unique creative flair all into a package that is disturbing and at times deeply unsettling.

It is survival horror right down to the limited effectiveness of your pistol and the scarcity of resources and manages to be thoroughly unnerving despite its low pixel density. The storyline has you questioning everything – even your own character – throughout and is the thing that will keep you coming back if you can bear the incredible tension the game’s atmosphere creates.

Score: 8/10