Maddening difficulty. I started it, and decided I’d rather finish my 4th playthrough on hard before I tried it. I want to get all 4 stories first.
It is significantly harder, at least in the beginning which is all the farther I got. Experience gains are heavily slashed, you’re going to be well behind the curve in levels in the beginning and will probably have to stick to a small crew because you can’t spread out the xp. Because you don’t have the levels you miss a lot more often and the enemy hits more often, and harder.
I’m not sure if you get caught up towards the end or not as I only did perhaps 5 or 6 months before I decided I wanted to see the stories play out first and then got distracted by other games. From what I played though this was exactly what I wanted out of the difficulty bump so I will eventually get to it.