Survival Mode is the hardest difficulty on Fallout 4 and changes a few things:
1. You can't fast travel
2. You have thirst, hunger, adrenaline and need sleep
3. The only way to save is to sleep in a bed
4. Most threats are not visible on the compass
5. You don't heal from food until "Well-fed"
6. Chems affect the immune system
Plus a lot more, I'm just playing to kind of show that and see how well I do in survival mode. I am in no way taking this seriously although I AM trying. Just having a little fun.
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