As far as I remember I was near some bandit settlement and I was out of medkits and food. Tho I admit that once I had a part that made me totally mad. Game is hard only if you allow it to 'screw' you :) Overall instead of mindless shooting like in CoD you need to actively search for cover (enemies can throw grenade pretty accurately), be carefull (sneaking is helpfull a lot), search for supplies etc etc. Especially enemies with shotguns - one shot and you are dead. You can still choose the difficulty level and overall the hard part in this game is that the enemies hit hard in early parts where you dont have a good armor. I wouldnt call it cruel or torturing as this guy said
The game is harder than your typical FPS shooter but its not as hard as dunno, Souls series or smth.
