Alex is one of the first characters that you are introduced to in the present in The Dark Pictures: Man of Medan. You can make him propose to his girlfriend early on in the game, so you definitely want to see him survive until the end along with his now fiance if you made that choice. This guide will specifically focus on how to keep Alex alive with his own decisions, with us leaving the overall story reasons for surviving as a group or not being left to another guide.
While characters such as Julia and Conrad can die as early as the original boat, Alex actually has to wait awhile before he can potentially die. This first sequence comes in the part where both Alex and Julia are knocked into the water and there are a bunch of Alex doppelgangers around for some reason. Both will go through a number of QTE sequences here while trying to escape one of these Alex lookalikes. If you fail these and the doppelganger happens to have a knife, he will grab Alex as he’s nearly escaping from the area and stab him right in the neck with Julia watching.
Just like with Julia, Alex can also be killed in the section with the bad guy named Junior with a gun. You may not end up in this scenario depending on the characters chosen, but if Alex is here, make sure that you do not make him mad. Do not deny that the mist is real and try your best to calm him down. Make the wrong moves here and Alex can be shot.
As also mentioned in the Julia guide, there is a moment near the end of the game where Alex starts to lose his mind due to the mist and sees a bunch of rats and a monster. After the QTEs with the rats, you have the option to stab yourself, the monster, or do nothing. The best option here is to do nothing, as stabbing the monster will lead to the death of another group member due to it being a hallucination. You most definitely don’t want to stab yourself, as that also means the death for Alex outright.
Just like with Conrad, Alex can die in the final showdown with Olsen. Depend on which characters are remaining, you may end up as Alex in this sequence. Press the right buttons to avoid being crushed by the door and Alex will manage to survive this part of the game.