I haven't played it since beta but one thing that's worth noting is although it's perma death, you unlock new characters to play the game with through time survived which is added up after you die, so even a death is not totally wasted, since eventually you'll get characters with different (and more useful) perks/abilities, thus making it easier to survive longer in the future.
I loved the game in the early beta, I don't want to try and answer your questions since it's probably changed now and I'll give the wrong info but thinking about it now has made me want to play it more