Videos at the bottom of the page.

tl;dr:

Features:

• 25% slower reloading
  
• Falling damage lethal at 4 floors instead of 3
  
• Reduced player resistance by a flat 15 for energy and regular damage (tweakable with extra batch files)
  
• 3x player damage
  

• Type: bat addresistance to add 5 resistance (like if you're low level)
  
• Type: bat removeresistance to remove 5 resistance (like if you're high level)
  
• Half of your current armor resistance is generally pretty satisfying but this may not hold for high levels
  

• Set your difficulty to Survival
  
• Extract the batch files into your Fallout 4 directory where the .exe file is (e.g. G:\Steam\steamapps\common\Fallout 4). 
  
• In the game, open your console.
  
• Type: bat startrealism
  

• Type: bat stoprealism
  

What is this?

RDS is a batch file that changes 5 settings in the game to make the "Survival" difficulty setting MORE realistic. The word "more" is key here, since I can't change all sorts of things to make this work better. You'll still have to put a clip in a boss (but probably not 3 clips), for instance, but at least peons don't take 10 to the face to go down.

Note that you do not have to use the "Survival" difficulty setting, this will work for any setting, but "Survival" has some cool features and damage to the player is closer to realistic.

What did you do?

1. Reduced player reload speed from "frenetic" to "guy reloading a gun IRL." The value I use is a little less than the inverse of the fast reload perk, so when you get that perk it'll put the reload speed back to a "frenetic plus" instead of "crystal meth light speed."

2. Reduced fall damage. You'll now begin to take damage at 2 floors of falling distance (judging by the floors in the Museum of Freedom) with damage increasing dramatically between the 2nd and 3rd floor and totes killin' a guy with average health at 4 floors, which is the amount of floors people always say will probably kill you. This is just a bit scaled back from normal Fallout 4 fall damage, which is usually lethal right at 3 floors for someone with 4 or 5 stars in endurance.

3. Increased player damage (adjusted from a 1x multiplier to a 3x multiplier). NO LONGER do you have to autohotkey the shoot button and go make coffee while you slowly ping the deathclaw (that got himself stuck in the ditch) to death. This is a "Survival"-specific amount, you may want to reduce this if you don't play on Survival.

4. Reduced player damage and energy resistance. I reduce this by 15 but in the early stages this is problematic, and with just a batch file it's hard to remedy that. The very first time you get armor that makes a real difference is right at the Museum of Freedom, and there's no way to go past like 7 or 8 damage resistance (energy resistance is a little higher at this point). On the other hand, at later stages of the game -15 may not be much. I have added extra bat files to combat this problem. Follow instructions (below) to adjust at will.

Are there any problems with your stupid mod, JackArbiter?

Upon executing the main batch file you will find that the damage shown in your pipboy for normal guns immediately increases. HOWEVER, damage shown for energy weapons remains the same. I'm pretty sure I remember a bug like this in F:NV (I played around with weapon damage settings a few years back), but maybe not. Anyway, please be assured that energy weapons have 3x the damage they show. You just have to remember to make the conversion in your brain, sorry.

Also, while I think this should be pretty safe to run with since it only adjusts 5 settings, there may be some glitch with some setting being some value that destroys your save, your hard drive, your CPU, your PSU, and whichever leg is closest to the PSU when its critical failure causes a massive explosion. So, you know, don't come to me with your hospital bills.

Installation

1. Download
2. Extract the batch files into your Fallout 4 directory where the .exe file is (e.g. G:\Steam\steamapps\common\Fallout 4).
3. In the game, open your console (with ~ usually for 'mericans since we don't know what to do with that swooshy button other than that).
4. Type: bat startrealism

If you are in the early stage of the game and -15 resistance is more armor than you have, you might:
5. Type: bat addresistance
This will add 5 resistance back. Type it twice if you're in the early stage of the game (for a final result of -5 resistance).

Then, each five levels (5, 10, 15, etc.):
6. Type: bat removeresistance
Until you are back at -15 resistance, or you may keep going depending on how far your resistance goes. Half of your total armor resistance is about right given you deal 3x damage, but it's your choice.

Optional:
7. Get ANGRY about how much this isn't realistic
8. Type: bat stoprealism
9. Come complain here

In the video below I show you damage (by the player) before and after the batch file. The first time I opened the console was an accident, I don't execute the script until the save is reloaded midway through the video. Also, I stand around for a second taking damage to show I've got godmode on, it isn't an example of the reduced resistance.

Falling damage! This is almost exactly 3 floors given the height of the railing and the ramp you fall on top of. Jumping always makes a difference and your health may be different than mine, so you may want to adjust at some point.