The running around in Outlast II mostly consists of avoiding conflict with virtually every enemy in the game. Right from the outset, the game warns the player that Blake is not a fighter and must hide from enemies if he hopes to survive. He does this mostly by simply outrunning most enemies and hiding from them when trapped in close quarters. There are large portions of the game that are completely consumed by darkness requiring the use of the camcorder's night vision feature to have any visibility whatsoever. The player must be cautious however because utilizing this night-vision rapidly drains the camera's battery. Should they run out, Blake is caught wading through complete darkness just waiting to be picked off by an enemy. Thankfully, the difficulty settings don't effect the placements of healing items or batteries. The enemies simply deal more damage and more aggressively chase Blake should they spot him. It should also be noted that the difficulty can be reduced at any time but never increased once a lower one is chosen.
The game also has features two different sets of collectibles. One comes in the form of documents that expand the lore and the other in the form of filming during set piece events in the story for Blake's documentary.
Outlast II follows video journalist Blake Langermann through his decent into madness as he attempts to recover his wife Lynn from a violent band of religious fanatics. The story begins with Blake and Lynn flying over a desert in Arizona by helicopter. The two are planning on filming a documentary about a young girl who went missing in the region. After a brief exchange, the helicopter is brought down by a blinding flash of light that disables the machinery in the helicopter forcing a crash landing. Upon regaining consciousness, Blake is alone. A short walk down the ridge reveals that the pilot's body has been brutalized by the same fanatics that have seemingly abducted Lynn following the crash landing.
Blake proceeds through the village of fanatics carefully avoiding conflict and documenting the horrors via his video camera whenever possible. Throughout the entirety of the game, Blake is occasionally blasted by the same blinding white light that brought down the helicopter. After being hit with it, Blake is forced to relive a traumatizing series of events from his youth culminating in the suicide of his childhood crush Jessica at the Catholic school he once attended. Once a new piece of the story is uncovered, Blake snaps back to reality typically somewhere very different from where he was before.
He eventually meets back up with Lynn following a close call with the leader of the fanatics Sullivan Knoth in the village's church. The two of them flee into the woods before running right into a band of rival fanatics led by Val. Val is none other than the missing girl, now fully grown, that Blake and Lynn set out of find the truth of. Unfortunately, it would seem that both religious factions pose a serious threat to Blake. After becoming separated yet again, Blake is left to his own devices to pursue Val into the nearby mines.
His path is diverted into a mire region run by creatures known as the Scalled. The Scalled don't simply want to kill Blake but rather crucify him as their savior which they actually succeed in doing. Blake manages to free himself from their poorly constructed crucifix and proceeds back down a river by way of a tiny raft. The river ultimately leads him back to another entrance to the mines. Once inside, Blake finds Val preparing to perform a ritual on a now extremely pregnant Lynn. After being pretty awkwardly pinned by Val, Blake is hit with one final revelation about the truth of Jessica's murder. After returning to his senses, Blake flees with Lynn out of the mines.
The entire region is now consumed by a raging lightning storm. The two of them return to the church where they were last separated. Blake does his best to deliver the baby that he's adamant can't possibly be his. Lynn dies shortly after from blood loss but not before proclaiming that there's no baby despite Blake literally holding it in front of her. Blake sits with the crying baby. He is joined shortly after by Sullivan Knoth who proclaims the child to be the Antichrist. His birth is proof that the world is lost, and the end is nigh. Before slitting his own throat, he implores you to kill the baby in an attempt to appease God. Blake does not oblige his request and leaves the church. The entire surrounding area is covered in the corpses of dead fanatics who have committed suicide. One final flash of white light consumes Blake and the child. Blake shares one last prayer with a mutilated Jessica before the credits roll.
Blake can find a single hidden document while scouring the mines that details the Murkoff Corporation's meddling in the region. It would seem that they have expanded their nefarious microwave reconditioning experiments to a much larger test population. The resulting effect is what has presumably driven all these people completely insane. The fanatics have misinterpreted the flashes as direct messages and interventions from God when really it was just the Murkoff Corporation's reconditioning.
There is some debate over whether the plot takes place as presented over a single night or the reconditioning has forced Blake to lose all sense of time. The later would explain how Lynn could go from not pregnant at all to delivering a baby at the end. This doesn't however explain why she wouldn't be able to see the baby after the birth. The game offers no definite answer to this question especially considering Blake being subject to the reconditioning has made him an extremely unreliable narrator.