Despair is an unlockable trinket in Insane Pain Mod, a mod for The Binding of Isaac.

Increases the chance of Afflicted versions of mobs spawning by 15%.

After death, Afflicted mobs drop the following:
• 5 friendly flies - 60%
• 2 Bone Hearts/ Rotten Hearts - 30%
• Golden pickup - 20%
• Item from the Rotten Beggar item pool - 5% (1 time per floor)
• II - The High Priestess or II - The High Priestess? - 1%

Complete challenge: TRUE PAIN.

• Download Insane Pain Mod from the Steam Workshop.