I play on 25x. Can confirm that it requires a totally different lifestyle than what’s normally expected in Cataclysm. I usually also vastly crank up the item spawn rate for ultra-horde worlds, and have even once done a world with 50x spawn and 10x items(Which I don’t recommend, 5x works just fine). Regardless of it, I still find myself gravitating towards finding an area outside of the city, and fortifying it with double-thick trenches of pits. My favorite spots seem to be Mansions, because of how much living and storage space they have, as well as their distance from any sort of civilization. Extra points if they’re near a swamp or ant-mound for easy food.
Easily the most important trait too is SCOUT. So you can increase the distance at which you spot hordes on the overmap. Also loot Pawn Shops for obtaining binoculars, which increases it even further. The more you know about where the hordes are on the map, the better you are at planning safe routes through cities to loot. Challenging a 50x/25x horde is suicide until you’re quite far into the lategame, and have stuff like deathmobiles and power armour with arbitrarily high amounts of bionic energy.
It might seem like a horrible idea because of how big a Mansion is, but successfully fortifying one over the course of a season can be a greatly worthwhile investment. My own mansion is surrounded by pit-traps, and blade traps, and every single door in the entire mansion is Reinforced. The most heavily reinforced central tile of my mansion has multiple layers of reinforced doors, and my own bedroom has its walls replaced by Reinforced Concrete that not even a hulk can smash through.
Across from the bedroom is a well stocked kitchen with over a thousand ant eggs, and various comfort foods. Below that is my crafting room, containing a ‘vehicle’ with a vortex generator, and a bike pedal generator, which powers all my crafting shit. And to the right of the crafting room is the Armory and chapel to the Holy Slavshit trinity.