On the Edge of Madness is the name of an achievement included in the game with Patch 1.10. The goal of the player is to start as the 
阿兹特克, reach 95 doom, and then survive 20 years without increasing it to 100.
Strategy
The main factor of doom increase speed is the number of provinces owned by a 
Nahuatl country. It is also increased by 25 after passing a single religious reform. Since the player needs to have 5 vassals in order to reform, they should obtain them first. If the player finds this part of the game too hard, they could restart the campaign few times, until 
科利马 doesn't put Aztecs as rival, and therefore can be allied along with some Mayan nations.
Then, instead of passing reforms right away the player can conquer remaining countries (but leave at least a single one for later). After conquering and vassalizing most of Mesoamerica, the player should annex conquered countries, and immediately pass the chosen reform. After all 5 vassals break free from the Aztecs, player should release some of the annexed nations. It is reasonable to release only as many provinces, as are required to get the overextension lower than 100%. The rest of possible vassals should be created after reaching 95 doom. Doing this shall considerably slow down doom increase, and to lower already very high amount, the player should attack the country, which was left alone before, and therefore is not in truce with the Aztecs. With some aggressive gameplay, the player should lower doom to a safe amount. After 20 years the player will get the achievement.
It is worthwhile to note that this achievement can be earned even as a vassal of another nation. For example, one could get their doom to 95 and then allow oneself to be vassalized by another nation. You will cease accruing doom while you are a vassal and will then merely have to wait 20 years to get the achievement.