you sound like you are in a pretty desperate place. it sucks to reach out for help, knowing you need it, and to be rejected. but on the flip side of that, the positive thing you can look at is that while it seems bad, you are not that bad yet. I know that offers you no comfort. while your pdoc may not be available, where is your therapist? have you considered calling crisis hotlines to help you through those rough moments? they are there to listen? I find ways to detach, make deals with my suicidal thoughts. I cycle and know it comes and goes in waves. so I say if it is still this bad in a month then I can go ahead so then I stop thinking about it. by then I am usually feeling better or I make commitments I cant break. anything to get me thru. hang in there. pm me if you need to talk.