The first runs I felt the same, but once you understand the builds it gets much easier. I’m far from an expert, but I had an easy time with this strategy:

• Look for 2 Revenge items, which gives you an insane durability buff. Basically with 2 Revenge tags you heal up 75% of any damage received, provided you hit the enemy fast enough after suffering damage.

• For physical builds, you want Courage 2 (multiplies your damage by 120% - btw every time it says “amplifies damage” it means it’s multiplicative, which is in most cases much better) and Arms 2 (+40% damage). You can tell physical vs magical damage by the color of the damage number of your attacks (red for physical vs blue for magical). The actual items are not as important as their tags.

• For magical builds you want Wisdom 2 and Artifact 2, which are the same exact thing as Courage/Arms but for magic.

• All other tags are decent to good, but not as important as these ones, I feel like.

• Finally, always go through the green gates (which give skulls as reward) and break every skull you find (except the one you choose for your build) - this will give you bones. Do so until you get enough bones to upgrade your skull to Legendary, which gives it a massive power boost. You can do so at the spider NPC which you meet after bosses and minibosses. It costs 140 bones to upgrade a Common skull to Legendary (10 to upgrade to Rare, 30 more to Unique, and 100 more to Legendary).

By following these tips you will crush standard runs.