Triangles

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Is it an Imaginary Friend, or is it Schizophrenia?
By Moira McMahon, Researcher

In episode 317, Triangles, Cooper treats eleven year-old Maggie, who was pushed into a fountain by her bullying classmates. Maggie has a pretty big bruise on her head, but what concerns Cooper is that Maggie has an imaginary friend named Eli. Her peers ostracize her because she insists that Eli is real.

Her parents are divided about Eli. Her father thinks Maggie is bright and creative; Eli is just a part of his gifted daughter's imagination. Her mother is worried. She's afraid her daughter is withdrawn, in pain, and in need of help.

Cooper calls in Sheldon to consult. After meeting with Maggie, Sheldon doesn't think it's a social problem. Maggie's relationship with Eli isn't just vivid, she has to do what Eli tells her, even if Eli tells her to drown the family cat.

Sheldon diagnoses Maggie with schizophrenia, a mental illness in which patients are unable to distinguish between what is real and what is not. Hearing voices, paranoia, disorganized speech and thinking are some of the symptoms of this disease, and many patients, without treatment, are unable to keep employment. The vast majority of schizophrenics never harm another person, though their disease can leave them unable to take care of themselves.

The decision to treat a major psychiatric disorder in a child is heart wrenching. All psychiatric drugs have side effects and very few have any data following the long-term use in children. Perhaps even more difficult is accepting that someone you love will be struggling to stay in reality for the rest of her life. Once diagnosed, many experts believe that treating a disorder as early as possible is the best route to take. There are people with schizophrenia who, with treatment, are able to function in the world and lead a normal life. Maggie's best chance to be functional is to receive help now. While hopefully she won't have to be institutionalized, she will have to go to a hospital until she is stabilized on medication. After which she will work with therapists and her parents to have the best life she can.

But are they making the right decision? These medications may or may not work, and the side effects may harm her more than talking to an imaginary friend. With mental illness, every turn is a turn into the unknown. But to ignore her symptoms won't make them go away, especially when many medications offer new hope for mental health.

What do YOU think?