Burden mode is pretty fun but the problem is there's only 3 kinds of bad items. I think it would make the mode interesting if there were more bad item types such as:
Enemy speed up: all enemies move 50% faster for some time
Weak punch: enemies take multiple hits to be defeated, tstarting with 2 and either doubling or increasing for each iteration of the item you pick up
reverse arrow keys: your arrow keys are reversed for a time. Reverses again for each iteration
This is how I do it: Lie on a nice warm cozy bed, and dream dreams about how to rule the world!
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