Some people are playing on Very Hard instead of Survival Difficulty. There's really no reason to play Very Hard instead of Survival according to these modifiers! More realistic healing plus more legendaries = more fun!

I recently discovered the modifiers. The only difference between Very Hard and Survival is that Survival has the slower rate of healing mechanic, but you are compensated with more legendary spawns!

Normal: 100% damage by player, 100% damage to player, normal legendary spawn

Hard: 75% damage by player, 150% damage to player, 50% legendary spawn

Very Hard: 50% damage by player, 200% damage to player, 100% legendary spawn

Survival: 50% damage by player, 200% damage to player, 200% legendary spawn, slow rate of healing

I actually started out on Very Hard and switched over to Survival at level 9. It's been a blast so far!