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I have just finished my sixth and seventh full runs of The Binding of Isaac. After completing the sixth run, you do not unlock a new item but instead you just get the "Everything's Terrible!" achievement and the game informs you that it has just gotten harder:

So terrible!

However, on my seventh playthrough I did not notice anything unusually difficult. Just how does the game change to become more difficult?

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I haven't yet made it to Mom. This game is hard! –  Raven Dreamer Oct 8 '11 at 2:28
2  
@RavenDreamer Don't give up! The more you play this game, the easier it gets. Not only because you get better, but because you unlock better items over time. –  Aubergine Oct 8 '11 at 2:32
    
I killed mom yesterday after 16h –  NoneOfYourBusiness Apr 22 '13 at 17:35
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3 Answers

up vote 21 down vote accepted

According to comments on the wiki, "Everything is Terrible" makes alternate colored monsters and bosses more common. This is actually good, because alternate colored monsters tend to leave drops on kill.

According to the mechanics guide, it also makes Curses more common in Wrath of the Lamb.

Additionally, however, bosses drop one less heart pickup (heart, half-heart, spirit heart) than they previously did.

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bosses only drop one health drop instead of two, according to the wiki.

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Curses will appear more often (10%).

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Good to know. Where do you get such accurate figures from? –  Aubergine Jul 19 '12 at 13:01
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protected by Community Dec 16 '13 at 15:32

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