My 3-year-old son is always saying he wants us to hurt him and he wants cars to run him over. Is this normal?
T.H., AKRON, OHIO
Even at 3, it is not normal for a child to repeatedly talk about wanting to be hurt, child psychiatrists say. The child should be taken seriously and be evaluated by a psychiatrist, psychologist or social worker trained to work with preschoolers.
"As far as researchers know at this point, the impulse that drives a 3-year-old to say he wants to hurt himself is the same impulse that drives a 50-year-old who says he's going to kill himself," says Donald McKnew, a child psychiatrist in Washington, D.C., who spent more than two decades studying depressed children for the National Institutes of Health.
Dr. McKnew, co-author of the new book "Growing Up Sad: Childhood Depression and Its Treatment" (Norton, $25, $33 Canada), will never forget the time a 3 1/2 -year-old he was evaluating stood up in a chair and took a head-first dive onto the floor.
"I had asked him if he ever had thoughts of wanting to end his life," says Dr. McKnew, a clinical professor at George Washington University Medical School. Luckily, the boy was not hurt.
"He got up and said, 'See, I can't do it.' He had tried this many times before and was discouraged," Dr. McKnew says.
One parent from Pineville, N.C., says her child said similar things at age 3, but it turned out he was just trying to be manipulative.
"For example, he'd be eating cookies, and we'd tell him to only have two, and he'd get upset and say these things," Denise Chew says.
Dr. McKnew says all suicide attempts are manipulative, and he has seen so many depressed children that he takes them seriously until proven otherwise.
Gail Alexander, the director of child and adolescent psychiatry at the University of Texas Southwestern Medical Center, agrees. "A youngster who says these things is as suicidal as a youngster can get," she says.
It is very difficult to diagnose depression in a 3-year-old, Dr. McKnew says, which is why it is important to seek out someone with experience in the field.
Parents can start by asking for a referral from their primary health provider. But Dr. McKnew says parents shouldn't be surprised if they find themselves having to drive to the nearest university or children's medical center to find a qualified therapist.
Pub Date: 4/21/96