Despair

You are slowly overcome with despair and begin to give up.
Despair is a worse version of Apathy that can be permanent.
Each point of Despair increases the DC for Death Saves by 2. (OR subtract your Despair from all Critical Injury rolls).
When you can no longer succeed Death Saves, you drop to 0 HP and begin dying.

Recovery

When you complete a Night's Rest while having any Despair, make a Composure Save with DC 10 + Despair. If you succeed, one point of Despair is healed. If you fail, reduce your Despair by 1, but the effects of that Despair become permanent.
Some powerful magic can bring back your hope.

Type

Magical