Gaming without a HUD is a gift when you're up against triple damage from enemies and almost no resources.
Some games feature difficulty baked in: From Software's Souls games, The Witcher 2, Super Meatboy, Ninja Gaiden, and the whole era of Ninten-difficult gaming. I'm more fascinated by experiences where the difficulty changes the nature of the game itself. I don't really tout myself as a hardcore gamer, I'm a pretty mellow guy. So it earned me weird stares from friends when I told them I preferred Insanity difficulty for the Mass Effect series, that I got the Big Boss Emblem on Metal Gear Solid 4 (back before they added Trophies to PS3 games), and liked the European Extreme difficulty modes of the prior Metal Gear games.
These difficulties literally change the way the game has to be played. I started playing Mass Effect and ME2 on Insanity mode made that game and ME3 much more tactical. Squads had to be carefully placed and had to target the right enemy for maximum effectiveness and damage and you had to order them to use specific abilities at the right time. Similarly, in the recently released Metal Gear Solid V: Ground Zeroes, I found that my favorite way to play was on Hard difficulty with reflex mode turned off, while trying to get S-rankings for all missions. With reflex-mode turned off, you can't rely on Snake's reactive abilities, you just have to be good enough at stealth not to be seen, increasing the challenge intensely since Hard-mode enemies are much more perceptive.
These difficulties drastically change the way the games have to be played without interrupting game balance. It might be better to say that the games are balanced so that even at this level nothing ever feels cheap, simply more challenging.
I recently played through The Last of Us Remastered on its Grounded difficulty setting. Grounded also exists in the original PS3 release, but the nice thing about the PS4 version is that all the difficulties are available right away so you don't have to beat other modes to unlock them. The first thing that's noticeable with Grounded is that it has no immediate HUD. While it does throw up a targeting reticule when you arm a weapon, you can't see Joel's health or how many bullets you have in a weapon without opening the selection menu by using the D-pad. With the scarcity of resources, this is welcome since you won't miss the constant reminder of how screwed you are.
What's more immediately striking are other elements of the gameplay, some of which carry over from the difficultly one step lower, Survivor. You can't rely on Joel's hearing to locate enemies (the ability is completely removed), the rumbling sound that means you're about to be spotted, or Ellie quietly whispering an enemy's location. Gun combat is tuned so that the player is almost immediately fired upon if exposed, enemies are crack shots, and Joel can take a maximum damage of about two hits, if he isn't shot in the face—enemies do triple damage and supplies are even more scarce than Survivor mode—about the last thing you want to do is end up in a firefight.
Clickers require an even bigger shift in tactics, since they've gotten better at locating Joel and Ellie. You really have to hide if a clicker is nearby because if you're in the open and they click near you, you're toast; sitting silently is not enough. This makes the clicker sections extremely tense and I found myself holding my breath as I tried to move Joel and Ellie past them in an early subway section. Using bricks and bottles as distractions make huge encounters more manageable and avoiding combat when necessary becomes a necessity instead of a choice.
The battle with the first Bloater in a high-school gymnasium at first seemed horrendously difficult. The margin for error is extremely low; get hit by his spore balls, poof, you're done; get attacked by the ammo toting runners, you're done; if he gets anywhere remotely near you, you're done. For every encounter like the one in the video above, there must be at least 30 more similar to the encounter in the video below. Immediately after completing this particular sequence, I was killed by a pair of runners and had to do the whole thing over again.
Not seeing Joel's health drastically increases the intensity of encounters, since you never know whether the next punch from a runner will knock you back or kill you. I found myself checking my gun compulsively to make sure I still had ammo after every fight. It also makes resource management more of a challenge, as you have to gauge how hurt Joel is by how he moves—how slumped over he is or how much he stumbles. The choice between a molotov cocktail and a health pack is more difficult when you can't look at a health bar and need to judge how hurt he is by context.
It's a tribute to The Last of Us' design that even with the high difficulty of these encounters—I died many, many times in even the earliest sections of the game—that it never feels cheap. Surviving an encounter without dying actually starts to feel like an amazing accomplishment. In the Capital Building, after having died probably a dozen times upstairs, I finally made it to the section near the exit below and successfully escaped into the sewers without killing anyone or being spotted on the second try. I even let out an excited whisper, "YES!". trying to stay quiet as if the soldiers could hear me along with Joel and Ellie sneaking through the sewer.
That may be the greatest thing about Grounded difficulty, as without the HUD there's less of a sense that I'm outside of the game's drama and it pushes closer than ever to the feeling of being immersed in a movie, losing oneself in the experience. So often harder difficulties just mean amping up enemy damage or decreasing player damage, at times breaking the game altogether with artificial difficulty spikes, so it's great when time has been taken to make sure that games played at that level remain balanced.