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Check out the prebuilt stats in the game files, which is easier to do on a savegame where you can look essentialy at one hex file to get a full list of the settings.
Then once you know the presets, head to Custom Sandbox and play around with the sliders it gives you. The descriptions are fairly good at pointing what they do, and you can not only tweak it to the difficulty you like, you can go WAY beyond Apocalypse. Those last ones are probably not fun for long runs, but good to see how long you last against tall odds... after all, this is how you died.
* No infection (I know this is contentious)
* Superhuman strength zombies
* Fragile zombies
* Medium memory, eagle eyesight, max smell and hearing, no coordination
* Walkers only
* Extremely high zombie population
It's not for everyone, but I like turning off infection because it makes first aid actually useful, and it means a single mistake doesn't randomly end a run. With the animation update, superhuman strength, and extremely high populations, zombies are plenty deadly enough in my opinion.