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Modal spells usually justify their price by handing you one flexible answer at a fair rate; this one under-delivers on purpose, pricing its single-mode floor above what any of those modes are worth alone. Pick just one and you get a -1/-1 across your opponents' creatures (a mini-sweeper in the Shrivel and Nausea mold, mopping up tokens and X/1s rather than forcing a sacrifice), a two-card discard, or a three-point drain, and four mana is steep for any single one of those. The design bet is that a black deck willing to pay that rate is already the deck stuffing its bin with a spread of card types by mid-game, so delirium is less a bonus than the intended operating condition. The whole payoff sits on a binary cliff: below the threshold you take exactly one mode, and the instant you cross it the spell flips to "choose one or more," a single switch that converts a bad rate into a game-ending turn. Take all three and a -1/-1 sweep drains three, gains three, and strips two cards from a hand, closing against a stalled board while ripping away the answer that might have stabilized it. It rewards the self-mill, sacrifice, and spell-heavy shells already climbing toward delirium, asking nothing extra of them but patience: quiet utility before the yard fills, a haymaker after, on the strength of a condition those decks were going to satisfy regardless.