Hysteria is an ability that grants Alice Liddell temporary invincibility for a short period of time. To activate Hysteria, Alice must be near "the edge of sanity," which is on her last Roses. However, if Alice is in the Fleshmaiden dress, she can enter Hysteria at anytime, disregarding the amount of health she currently holds.
When Alice enters Hysteria, she screams, sending a deadly sound-wave as blood splashes around her. All of Wonderland is now seen through a gray slate, and Alice herself gains new-found superhuman strength and temporary invincibility. This phase also removes the heat-up effect on the Pepper Grinder and Teapot Cannon.
Alice is in all white except her black hair and eyes. However, in some instances, her hair also turns white although cut much shorter. She appears to have blood running from her eyes and mouth. Her arms are seeping with fresh blood, and her dress has a hole on her left breast.
The dress is heavily stained with blood, and her Omega pendant changes to the astronomical symbol for Pluto. Most of her weapons are covered in bandages soaked with blood.
Diamond Select Toys released a posable figure of Hysteria Alice in their Alice: Madness Returns line. While it was not included in the case assortments with Alice, Cheshire Cat and Card Guard, it was sold individually to comic shops and specialty stores via Diamond Comic Distributors' Previews catalog as a catalog exclusive. It comes with a bloody Vorpal Blade as well as deep red versions of the Pepper Grinder and Hobby Horse.
There are some mild differences between the Hysteria figure and the game edition, such as the fact that Alice is wearing her original Omega necklace rather than the astronomical symbol for Pluto. This is due to the fact that all editions of the Alice doll are created using the same mold, but only painted differently. The same problems are present in the Royal Suit edition of the figure.
- Hysteria is a term used to describe unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict. As Alice enters Hysteria only when she is close to death, this state could be caused by a fear of dying, or a fear of losing in a fight.
- In the real world, considering Alice's near-schizophrenic state, this would mean more violent visual and auditory hallucinations. The same could be said for Wonderland.
- When Alice enters Hysteria, mumbling voices can be heard all around her.
- Her appearance was similar to a ghost or paranormal person.
- It is similar to her Rage form in the first Alice.
- Alice in Hysteria mode resembles Anna, a character created by Kendare Blake, from the book Anna Dressed in Blood.