Thank all of you above for your posts. I think you have been very kind and I am crying now because sometimes it makes me cry to have people be nice to me when I feel this bad. Also - you give me some hope.

Rohag -I will look into getting some advocacy help. You have reminded me that I did that once, and it did make a difference. I had forgotten, as that was back in 2004, and I am not thinking real effectively.

You each make good observations. DepressedAlaskan - I think where I live has something to do with it. There is no first class anything in my state. I don't really blame the state. It's just a product of history.

I am sort of thinking about how I might pull myself up by my own bootstraps. That would be preferable to going inpatient at a place that has always been pretty crummy. Maybe if I could just start picking up the house and putting things in order. That has worked for me many times.

Still, I know as many times as I pull myself up, I will continue to have episodes of decompensation. That is what it means to have a chronic problem. It's chronic. I can be very well at times. My goal is to make those times last longer. My goal is to reduce the frequency of downturns and to reduce how long they last. I might be more successful over the long haul, if I was plugged into an appropriate level of services. Not to foster dependency. I could game the system and get a lot more than I am getting. I am trying to ask only for what I need when I really am in need.

Where I go is a public facility. Those places always serve a population bigger than they can really do the best by everyone for. It becomes a case of prioritizing the most severely needy. I understand the realities.

My primary care doctor seems to be above average good. We have a pleasant relationship, so I hate to ruin it by telling him about psych stuff. I'm at an age where, unfortunately, I am starting to have a number of health concerns. I'm afraid that if I give him too many things to think about, then he won't be able to do a good job on any one thing.

What you say BlueMountains, is an idea I will use. I will tell my primary care doctor that I am not getting adequate follow up at the psych center. He seems genuinely caring.

There are ways of expressing dissatisfaction and I would like to do that, but carefully in a way that does not just get me labeled a pain in the butt.

I feel better just thinking about what has been suggested here. Maybe I can go make the bed, while I feel a little better. Then - maybe - do something else.

Thank you for believing me. I wouldn't say I am seriously depressed if I weren't. It's an awful feeling of failure to get this way.