There are additional difficulties to the mod for those who want a challenge (or are nuts).
The difficulties with the affix "Hard", mean that your character will start with 20 Max Health, instead of 100.
The 1 Health for good Difficulty means that if you get touched, your character will visit guide in the underworld.
N Terraria 6
Now you can change the difficult at any time in the N Terraria Options, into the modes "hardcore RPG" and "capped hardcore RPG", that makes all enemies stronger.