A recurring theme from season to season is that the earthly life is full of everyday horrors, including adultery, drug use, cruelty, self-mutilation. Horrors also come from supernatural sources: ghosts, witches, demonic clowns.
Violent scenes are both sudden and shocking, with both real and fantastical elements: a school shooting, a rape from a demon-like character, an acid attack, amputations, decapitation, suicide, a terrible scene that involves bleach and enemas. Intense blood and gore is shown. Visuals include bullying with physical violence, bloody stabbings, shootings, eviscerations, dead bodies, and shots of self-mutilation scars. Realistic dead, bloody animals are shown onscreen. A late-term miscarriage is also described in detail, and characters take delight in killing, torturing, and maiming.
Teens are sexually active. Adult characters also engage in sometimes disturbing sex that includes fantasy rape, masturbation, and some partial nudity (bare buttocks, etc.). There are rape scenes in several seasons; one particularly notorious one involves a supernatural rape, another has aspects of bestiality and incest between a mother and son. Sex with a disabled character is fetishized in one season.
Frequent use of unbleeped "s--t" in many forms -- from "s--thead" to "bulls--t." Also audible: "c--ksucker," "p---y," "d--k," "bitch," "coke whore," etc. Teen characters swear around their parents.
Drinking, Drugs & Smoking
Both teen and adult characters smoke cigarettes. Depending on the season, characters variously drink (including underage kids), use cocaine, heroin, and marijuana. Some seasons revolve heavily around characters with drug habits.