Like the rest of her siblings, Despair is neither a mortal being nor a god, she is the personification of despair itself.

"Take away the despair and there is nothing left. Nothing but an empty room, and a hook of the perfect shape and size for snagging your heart." -Endless Nights

Usually seen as a naked, gray, short, rotund woman, the only ornament she carries is a ring with a sharp fishhook on it which she uses to tear into her own flesh as she tears into the hearts of mortals wallowing in her domain. Her realm is grey as she is, filled with windows that open to mirrors in the mortal world where she can watch beings enter the darkest depth of their lives. The floor is covered in mist and rats scuttle around in it, her pets. She says very little and is patient.

It has been spoken of that this is the second aspect of Despair and that her predecessor was the first of the The Endless to be destroyed. How or why is not known. It is also said “that another aspect of one of us had reassumed the position.” It is unclear if this Despair was, like Daniel, another being who became one the personification of one of the Endless or if she was another Endless entirely who became Despair.

The first form of Despair is similar to her second form, except she is taller, tattooed with intricate red lines and she was also more talkative.

Despair is Desire's twin and they are close, speaking frequently and often ganging up. In 19th century San Francisco, Despair challenged Dream in a contest over a failed business man to see which of them had more sway over the lives of mortals. Dream gave Joshua Abraham Norton the dream of being Emperor Norton I, which kept him from falling into depths of despair, as well as the traps set by Desire and Delirium.

Despair also seems to have been very fond of her elder brother Destruction.