I'll try my best to keep this brief and can follow up with details if anyone asks for specifics. If this post is too long, you can skip to the last couple of paragraphs, and/or skim the first few. In a nutshell, I feel I am in need of hospitalization, but am unsure of whether or not my feelings are unjustified and how to go about getting help. I fear a trip to the ER (don't know how I'll get there without a car) will result in me being sent away feeling like an idiot whose issues are not all that serious or deserving of medical help. In regards to some background information, I have been suffering from on/off depression since high school, when a teacher reported me to my counselor who literally threatened me with the 72 Hour Hold (I think to scare me into thinking my "depression" was trivial or stupid or disrespectful of those who /really/ were suicidal); it didn't happen and when my parents picked me up from school they scoffed at and joked about it. I am Asian-American and have parents who do not really believe in receiving medical attention for 'feeling blue' or other 'little' problems. In college I was diagnosed with ADHD-PI, which I kept secret from my family and most of my friends. The medication for that helped, but did not help recurrent bouts of depression. Fast forward to the present - I am now in my /fifth/ year of college, majoring in engineering. I can safely say I have/had been mildly depressed for about a year, primarily due to feelings of failure as a student aspiring to attend grad school and remain in academia, become a professor. It may have been slightly triggered by rejections from every summer internship and research program I applied to, despite a decent GPA and having performed well in the handful of graduate courses I have taken. I essentially spent this past year wasting away my parents' money, dropping classes, and not performing well. I am at least not conscious of any affect it may have had, but I broke up with my boyfriend (of ~2.5 years) last November; just to make a note of it. A few months ago I was prescribed both an antidepressant and Strattera, but stopped taking it a couple months ago. I had gotten the attention of my psychiatrist (in regards to depression, finally) because he noticed I had gone from ~110-115 pounds to less than 100 pounds due to a lack of appetite. Partially because I knew I would not be able to continue taking the medication after college (without parents knowing - until/unless I get a job, I suppose) and I was feeling better, and partially since my doctor did not want me to take both medications in conjunction with my usual Adderall prescription, which I opted for in favor of the other two. [I haven't taken any Adderall in a couple weeks; just a note.] For the past few weeks, at least four or five, I have been severely depressed. I haven't been to any of my classes, I haven't left my apartment aside from the occasional trash disposal. I sometimes suffer from bouts of insomnia and loss of appetite, and other times bouts of hypersomnia and intense fatigue. I have socially isolated myself - I haven't called my parents in a couple of months, I have avoided logging into any social network sites or chat clients. In the past couple weeks I have been having recurring thoughts of death and suicide, but think my desire to live presently outweighs the pain I feel. On the other hand, I worry the scales may tip at any moment and I may not be able to fight off the desire to end my life. The only means I can think of to commit suicide are (un)fortunately xxxxxxxxxxx. There is no specific plan or date/time set up, but nevertheless feel I am in need of help. ... So much for briefness, that was really fucking long. I apologize. I haven't gotten much sleep aside from naps for the past three or so days (honestly can't remember) and have spent these nights debating whether or not to call the nearby emergency psychiatric services; out of fear that I may be sent away and billed, for one, and also out of the fear that my school's health insurance will not cover voluntary inpatient treatment. I cannot have my parents burdened with hospital bills, partially due to the fact that I have thrown away the money they have spent on me for the past wasted year of school. Also because I want to avoid having them know of my problems since I want to avoid the scoffing, joking, sympathy, anything, etc. I am contemplating calling for an appointment with my school's counseling services, but worry they won't be able to see me within the next couple days. I am pretty sure my issues do not warrant a 911 call, since the only self-harm I really engage in is a nervous habit of skin-picking. The only steps I have thus far taken in getting help is this thread post and an e-mail to Samaritans.org - so far unanswered - because I cannot bring myself to use the phone (I generally HATE using the phone - it has been off for weeks as a means of avoiding seeing people trying to contact me) to call any helplines or anything. That's about it, in sum. I am asking anyone for advice as to what steps would be advisable to take, despite fears of costs of going to an ER and/or being sent away and feeling absolutely stupid for misconstruing my problems for an actual problem (then having no idea what to do - I REALLY dislike my current psychiatrist and do not want to see him) and/or a potential hospital stay not being covered by insurance and my parents having to foot the bill... I spent the past couple of days looking into information regarding my insurance and such, but could not find any helpful or conclusive answers.