Answer
And before anyone asks, yes, I'm fine.
The character shown here usually never expresses a single emotion. In nearly every imagine I've composed of her in the last few years, she's worn a blank expression. (Blank to me, of course, some thought she appeared constantly pissed off.)
Below that facade, she carries a deep hatred for herself. She believes that she contaminates everyone around her, and that she doesn't deserve anyone's kindness or compassion. Her greatest wish it to feel...nothing. She wants to go numb, never to feel anything at all. A wish like that, however, is not easily granted. The only real way to do this is to die. And despite her longing for her own end, she can't bring herself to do it. She's afraid of it, and for that she thinks herself a coward.
People may say that "life requires more courage". I would like to disagree. You can expect things from life. Eating, fucking, shitting, taxes. These are things of which one can be relatively certain, but what of death? No one really knows for sure. No religion throughout time agrees. There's no aristoleian proof that we do nothing more than rot in the ground. Considering all of humanity's musing on the subject, it's tantamount to the greatest unknown in the universe. To willingly embrace that nothingness, that unknown, does indeed require more courage than most want to admit.
So, I granted Akisa's wish. And for the first time since I drew her, she's actually smiling.