Imagine if there's a toggle for a harder mode, that even your excretory systems is trying to get your attention toward them...
...On a second thought, that would probably be too stressful to regulate body status, since it would increase if you quench the thirst or hunger.
Anyway ignore my suggestion, this is a really good game for those who seek brutal and tough survival games, doesn't hurt to try, really. (Died and panicked many times.)