Every "I need ___" statement is an implicit if/then statement. At its most basic level, usually the "If" is "If I want to avoid dying in the immediate or near future," as in "I need oxygen (if I want to survive for at least another ten minutes)," "I need water (if I want to survive for at least the next several days)," "I need food (if I want to survive at least the next month)," etc.
Of course, those needs rapidly become more conditional, and more fungible, as they increase in complexity. "I need this job" approximates to "I need an income" when the rest of the sentence is "If I want to keep paying my bills," and approximates to "I need the support of an institution or community" when the rest of the sentence is "If I want to keep living comfortably and sustain my current lifestyle."
I've always been really hesitant to use "I need" statements, mainly I think because they're often an unintentional invitation to let other people attack my priorities or goals, and I haven't historically been surrounded by exceptionally supportive people. "I need a therapist" doesn't always go over well with people who think you're faking mental illness to get special treatment. "I need to be left alone right now" tends to escalate situations when you're talking to someone who doesn't understand what a panic attack is.
I also hesitate with them because I don't want to place unfair burdens on other people who may also struggle with saying no to things. I've been somewhat in crisis for the past several days, and it feels like an extraordinary challenge to figure out how to reach out to people, to say "I need help in a way that feels absolutely desperate and urgent," while still making it clear "It's okay if you say no, I'll get through this." I'm doing alright just at the moment but it's still hard to conceptualize that request in a clear and fluid way. When I'm worse off my body physically rebels when I try to think that problem through.
This feels like a difficulty in the use of language for communicating clear ideas -- how do I coordinate the passage of precisely the degree of urgency that's justified when I can't even figure it out myself? -- but really it's a problem of potentially-conflicting values -- I need this to relieve some of the pain I'm experiencing, but is there a way to ask for it without risking the escalation of pain that would come from told I can't have the help I'm asking for?
Obviously there isn't. Most often the answer is that I kind of have to suck it up and risk more severe pain over a longer period of time. Like that time I broke my ankle and the only way to pursue treatment was to be transported to a hospital, rather than sitting on the walkway outside my high school in the middle of winter, where on the one hand I could avoid moving it, but on the other hand I would eventually die of hypothermia. (Fun fact: Urgent problems get worse when you ignore them!)
Speaking of which: I'm going to go talk to my college's financial aid people, because I need someone to tell me what I can do to figure out my finances in the near future, at the risk of them telling me they have no help to give me.