In the case of Sanguinarians and Psi vampires, the person undergoing the awakening will be altered physically and mentally.

These changes often include an increased sensitivity to light and particularly to sunlight, a growing affinity for night and darkness, having one's circadian rhythm become inverted and switching from a nocturnal to a diurnal sleeping schedule, and experiencing the first symptoms of the thirst.

Many experience acute feelings of isolation and alienation during this process, as their changing nature distances them increasingly from their "normal" family and friends.