It feels like an actual apocalypse survival simulator now, and I don't think I can go back. Feral ghouls were killing me in two hits.
It took me an hour to successfully clear Super Duper Mart, which is crazy but I think I was under-leveled and didn't have the correct gear to take it on. You can utilize way more items in Survival, empty bottles actually have use(fill them up with dirty water) and there's some unique items that only show up in this mode as well, like antibiotics or medicine for fending off different symptoms. There's no quick-save so you need to pick your battles. In Survival, there's no fast travel, so you have to walk everywhere and plan your trips.
In Vanilla, you can play this game like an FPS and just quest to the end and miss a ton of game. I feel like this is the way the game was meant to be played. Better weather, better textures, things like that. I started in Survival mode with a nice list of realistic gun mods and a lot of visual upgrades. I decided to do something with my Steam version of FO4 recently.