I don't outwardly appear that bad, either, and I would encourage you to behave and dress like you normally would. If you go to the ER, just tell them that you need help now. I don't think there's any way a doctor wouldn't take you seriously. As part of screening, an ER doc will sometimes ask what it is you want to have happen. So think about that, Brownmike. Surrendering and allowing others to help can be a great relief. If you think that less restrictive measures will help, then that's a viable option, too.