Games like BreakDespair2D
Games like BreakDespair2D include Bit Blaster XL, BALL x PIT, Planes, Bullets and Vodka, DoDonPachi Resurrection, and Sky Force Reloaded. We matched them by the tags players give BreakDespair2D on Steam (Shoot 'Em Up, Bullet Hell, Top-Down Shooter, Action, and PvE): closest matches first, and among equally close ones the better-known games.

Bit Blaster XL
Shared: Shoot 'Em Up · Bullet Hell · Shooter

BALL x PIT
Shared: Action · Bullet Hell · Shoot 'Em Up

Planes, Bullets and Vodka
Shared: Shoot 'Em Up · Action · Bullet Hell

DoDonPachi Resurrection
Shared: Shoot 'Em Up · Top-Down Shooter · Bullet Hell

Sky Force Reloaded
Shared: Shoot 'Em Up · Bullet Hell · Top-Down Shooter

Nova Drift
Shared: Shoot 'Em Up · Bullet Hell · Shooter

WOWOWOW KORONE BOX
Shared: Shoot 'Em Up · Bullet Hell · Action

ZeroRanger
Shared: Shoot 'Em Up · Bullet Hell · Action

20 Minutes Till Dawn
Shared: Bullet Hell · Shoot 'Em Up · Top-Down Shooter

Vampire Survivors
Shared: Bullet Hell · 2D · Action

Touhou Koumakyou: New Classic - the Embodiment of Scarlet Devil
Shared: Shoot 'Em Up · Bullet Hell · Action

Touhou Juuouen 〜 Unfinished Dream of All Living Ghost.
Shared: Shoot 'Em Up · Bullet Hell · Action

Star Saviors
Shared: Shoot 'Em Up · Bullet Hell · Action

HELLDIVERS™ 2
Shared: PvE · Action · Shooter

Time Wasters
Shared: Bullet Hell · Shoot 'Em Up · 2D

Revolution Ace
Shared: Shoot 'Em Up · Bullet Hell · Action

Beat Hazard
Shared: Bullet Hell · Shoot 'Em Up · 2D

LUFTRAUSERS
Shared: Bullet Hell · Action · Shoot 'Em Up

DRAINUS
Shared: Shoot 'Em Up · Action · Shooter

Ikaruga
Shared: Shoot 'Em Up · Bullet Hell · Action

Touhou Kinjoukyou ~ Fossilized Wonders.
Shared: Shoot 'Em Up · Bullet Hell · Action

BLUE REVOLVER
Shared: Shoot 'Em Up · Bullet Hell · Action

Touhou Kouryudou ~ Unconnected Marketeers.
Shared: Shoot 'Em Up · Bullet Hell · Action

SNKRX
Shared: Shoot 'Em Up · Top-Down Shooter · Shooter