How I Ended Up On the Internet Researching Psychosis

I've mentioned many times on this blog about Oksana's imaginary people.  She's always had them and they've always been a part of our lives.  We feel sure that she created them in the orphanage as a coping mechanism.  In the last few months we have seen those people consume her.  It is all she does, it is all she talks about, it is all she thinks about.  That world is as real to her as our world.  There are multiple people and animals involved in this world.  Recently she has indicated seeing black things on her floor at night that scare her.  She spent an hour this weekend looking for a bird that she heard chirping, and of course we heard nothing.  When asked if she sees and hears her imaginary friends she will tell you yes.  She pointed one out to me the other day and told me what he looked like.  His name is Betch.  He has dark skin.  Today at school one of the paras had a scratchy voice.  Apparently this set her off.  Oksana expressed that she was very irritated by her voice.  I have no idea why since we have had our fair share of scratchy voices and I'm sure this para wasn't the first one at school to ever have a scratchy voice.  For some reason she couldn't cope with that today.  She was on the playground and starting to get agitated.  Apparently Betch showed up during this time and she told him he had to go away.  At some point she snapped and went after a kid on the playground.  They had to restrain her to calm her down.  That's actually the first time in months I have gotten the "we had to restrain her" call from the principal.  They came frequently at the beginning of the year. 

We saw her psychiatrist yesterday and obviously I voiced my concern about this imaginary world and the impact it is having on her.  She heard me out and even talked to Oksana about it.  She addressed the black things on her floor and told her that they are not welcome in our home.  She went on to talk to her about  how to get them to leave, told her that no one but our family is allowed here, and told her that especially if someone is  mean or scaring her they are not welcome.  Despite the fact that Oksana says they scare her she was very reluctant to let them go.  She argued with the psychiatrist about why they could stay.  She said there are nice ones, she can control them, they just need a family, etc.  She doesn't want to let them go.  So the psychiatrist has decided it is time for Oksana to see a therapist.  She said that as of right now we aren't calling this psychosis but we also aren't ruling it out.  She is hoping that the therapist can help sort through some of this and based on the kind of progress that Oksana makes we will see if there is any true psychosis involved. 

I don't know what to think.  Is this hallucinations or is it just that the line between reality and fantasy are so blurred for her that she really doesn't know which is which?  I found this video recently.  Oksana does not have schizophrenia.  If she is hallucinating she would have bipolar with psychosis.  Still, this video had me picking my jaw up off the ground.  I've never seen another child do this with imaginary people.