ATC is not expected to have to guess at what a pilot needs to do and then sort out his problems for him. This is why we have to say, "Mayday, Mayday, Mayday" or at least in plain speech that magic word, "emergency." Saying that you need a lower altitude, well, yes, okay, but stand by for that; that could take a few minutes to work out on a routine basis.
Wow, brilliant idea old chap, why didn't all of us pilots think of that!
Hopefully there will be some more positive input on this thread, since alarms and training seem to be falling short in several unfortunate instances.