Insanity is a trade-off gear perk on the Vaas Wraps that raises your weapon damage but lowers your general defense. It is a glass-cannon pick for aggressive players.
Every gun you use hits harder, but you take more damage. Fights end faster, in your favour or not.
Good for skilled players who clear rooms quickly. On harder difficulties the lower defense can get you killed.
No Time to Spare and First Aid Kit help you recover from the extra damage you take.