If you loved the JSawyer Fallout: New Vegas mod, BOY DO I HAVE AN OFFER FOR YOU! A new mod for Skyrim, known as "Reqiuem", is getting some buzz for its oldschool approach to RPG difficulty. To put it another way, it makes vanilla Skyrim look like My Little Pony: Rainbow Starlight Adventure (or whatever the hell).
So, if you're man enough for nerfed sneaking, slow travel, brutally punishing combat, and other exhausting mechanics, hit the source to download and install. If you're looking for an overhaul that doesn't make you hate yourself, consider Skyrim Redone.