The Medium - Deluxe Edition Download PC

They took cues from Japanese horror games like Silent Hill and Resident Evil which used fixed cameras and third-person perspective to better present the game for players to see both worlds at the same time while capturing the spirit of these horror games. This also helped to enhance the player's immersion in the game. 

They maintained this split-screen concept in cutscenes as well, though frequently switching up camera angles. This partially was used to mask unrendered details in some settings, but was also used to keep a sense of unease as when Marianne has a conversation with characters in the spirit world, while her real self is shown interacting with nothing.

They had chosen Poland during the 1990s, following its transition from a communistic to a democratic government in 1989, as the game's setting, as the nation's history represented the nature of duality, an overarching theme of the game. 

Aware that the post-war era as well as the more recent democratic era were not well known to an international audience, part of Bloober Team's goal was to make the setting approachable to the wide audience, and covered both aspects of these parts of Poland's history within the game. 

They recognized that with the success of their prior game Observer as well as interest in television shows about the Eastern Bloc such as Chernobyl and Dark, the Polish setting would be of interest to players. The Soviet-era Hotel Niwa is based on a one-to-one rendition of the existing Hotel Cracovia located in Kraków. 

The opening apartments at the start of the game, while based on a real building in Kraków, is an Easter egg to Observer: System Redux, where the same building is also present in that game's future setting. They modelled the supernatural setting after Zdzisław Beksiński's dystopian surrealist artwork.

Audio for the game was made by a "Silent Hill dream team" according to Bloober Team, including Silent Hill composer Akira Yamaoka, singer Mary Elizabeth McGlynn, and voice actor Troy Baker, Yamaoka was persuaded to take on the music when Piejko gave him a gameplay demonstration. 

Yamaoka and composer Arkadiusz Reikowski were tasked with scoring the physical and spiritual plane, respectively. Using synthesiser and analogue sounds, Reikowski likened his approach to that of Stranger Things and Chernobyl. 

Baker voices the primary antagonist, known as the Maw, for whom another actor performed the motion capture on stilts. Actor Kelly Burke provided the voice for protagonist Marianne, with Weronika Rosati and Marcin Dorociński providing design and motion capture for Marianne and Thomas within the game. 

The developers had planned out the camera and actor's direction for motion capture prior to the onset of the COVID-19 pandemic, which made it easy to complete the motion capture sessions under COVID-19 regulations during 2020. Overall, the game has about 90 minutes of motion capture. 

While the game takes place in Poland, Bloober Team specifically chose to have the characters speak with American Mid-Atlantic accents as to make the game approachable. The team had planned to include the option to switch dialog to Polish voice-overs with English subtitles but the pandemic caused them to fall back on this plan.

Following its initial 2012 announcement and subsequent drawback, The Medium was reannounced in May 2020 as a Microsoft Windows and Xbox Series X/S title. Originally scheduled for 10 December 2020, the release was eventually delayed to 28 January 2021 due to the pandemic.