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This Is Us Uses Randall to Remind Us All How Important Mental Self-Care Is — & Why We Need to Talk About It

Spoiler alert: This article contains key plot points of This Is Us Season 4, Episode 11, titled “A Hell of a Week: Part One.” 

We all know This Is Us loves cliffhangers, and last week’s mid-season premiere gave us one tense enough to give anyone anxiety. The fact that the final scene involved Randall, who already struggles with major anxiety issues, didn’t bode well. So, we all (Randall included) were ready for a bit of relief — or resolution, or maybe simply confirmation another Pearson man wasn’t about to die — with this week’s episode. What we got was a study in living with anxiety, and why it’s so important to reach out when you feel like you’re drowning in it.

Listen, we get it. The fact that the final few seconds of the episode teased Kevin reconciling with Sophie is exciting. It’s flashy. It would have been easy to angle a headline around that glimpse. But Kevin will get his time next week. NBC devoted an entire episode tonight to the stigma surrounding mental health. To the fact that far too many people feel as though they can’t be honest when they’re struggling — the perception that vulnerability surrounding mental health is a character flaw or weakness. And that’s more important than a juicy dating storyline, or some heroic resolution wrapped up in a neat and tidy bow.

So, 5-second recap from last week: After coming home from a late-night flight last week, Randall walked into the kitchen after returning from a late-night flight last week, and there an armed intruder stood. Or, as he described it this week in a phone call to Kevin, he came “face-to-face with Christian Slater’s creepy doppelganger.” Long story short, Randall tosses down some money, the thief decides it’s better to take it and out the intruder goes.

But while Randall, Beth and the girls escaped any physical harm, it becomes more evident as the episode progresses that Randall’s psyche has suffered some serious damage. Between his longstanding mental health issues, dealing with Rebecca’s cognitive issues, his big trip to LA and now the break-in, Randall is basically a walking bundle of exposed nerves. In this Randall-centric episode, we get a tiny taste of what that must feel like.

Because it’s This Is Us, the episode’s heightened level of anxiety is layered artfully between past and present. In the past, we see more instances of Randall’s anxiety — what they were like before Jack died, and how they intensified after Jack’s death. We watch as Jack attempts to put the Big Three to bed one night, only to be woken up multiple times by a fearful Jack. He’s afraid of monsters. Jack lays down beside him to sleep, but an anxious Randall is still plagued by worry.

He tries to be honest with Jack about his fears, and Jack is a sweet dad. Yet, we also see what is possibly the start of a harmful pattern for Randall. After Jack sneaks out of the bedroom, Randall soon follows. When Jack reassures him there are no monsters, Randall interjects that he’s still scared. So, Jack — in a totally relatable exhausted parent moment — makes a big ask of Randall: Keep being low-key, buddy, because your brother and sister are so high-maintenance.

Flash forward to Randall’s college years, and a fire alarm in his school causes him to start experiencing intense nightmares much like the ones he had shortly after Jack’s death. He starts to tell Rebecca about it, but she’s a single mom with moody teens. Of course she’s going to be distracted. So, being the dutiful low-key son he is, Randall tries to deal with the anxiety on his own.

This turns into a motif in both Randall’s past and his present. In the present, he reaches out to Kevin the night after the break-in. Obviously shaken, he starts to open up to his brother about how jarred he feels: about why he bolts upright at the slightest sound, why he’s watching The Great British Baking Show in the middle of the night, why he has sporting equipment stashed all over the house in case he needs to defend his family.

And while Kevin is receptive, Randall stops short. But when one of the girls triggers their new alarm system on their first day having it, it shakes Randall even more. Then, he and Beth realize the robber had been in their room and had stolen his cufflinks and her topaz earrings. The nightmares come back and, just like they presented when Randall was younger, he’s powerless in them. No one can hear his screams.

A town hall meeting with throngs of “concerned” citizens doesn’t help. Beth — who we discover in the flashbacks has long tried to help Randall manage his anxiety — insists Randall takes a day off so they can discuss how to get a handle on his mental health. Randall is Randall, though, and he decides to go on a run first. Before he can make it off his stoop, a friend and local constituent Darnell (Omar Epps) shows up. And if you paid attention to nothing else in the episode, I hope it was this.

Darnell shares his own story of how he used to be a live wire too, until he started talking to someone about his issues. “Look, bro, I get it. Us men of a certain shade, we’re not used to talking. But that’s therapy… talking. It doesn’t even have to be that deep,” Darnell tells Randall, who quickly rebuffs him. By the time Randall jogs around a corner and comes across a woman being mugged, he has lost any semblance of control. So, he loses it.

He breaks his hand on the mugger’s face and, because Randall is still not ready to deal with his mental health, the instance nearly breaks him. When he walks into his office and his staff starts heralding him as a hero, he simply turns around and walks out.

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In flashbacks, we see two important seeds of wisdom planted in young Randall’s psyche. As Jack carries him to bed, the father-of-three thanks Randall for “being brave enough” to admit he’s scared so that his dad can help him fix it. And from Beth, then his college girlfriend, Randall is told that sharing her dreams about having no control gave her control over them. “Just talk to someone, like a counselor,” she says. “It’s better than torturing yourself; trust me.”

When Randall walks out of his office, his pain is palpable. You can feel his discomfort to the point that it’s difficult to watch. He locks himself in the bathroom and calls Kevin, this time finally ready to concede that he isn’t okay. He unloads, and Kevin slides into Jack-mode, promising to be the one who gets Kevin through this crisis.

And that’s a start.

NBC did a beautiful job this week of relaying just how insidious anxiety is — how it looms over everything you do, like a specter. It doesn’t just present in stereotypical panic attacks, although those happen as well. It’s lying in bed at night after everyone else has gone to sleep, your mind and pulse racing. It’s being plagued by nightmares when you finally do fall asleep. It’s obsessing over details that seem unimportant to others, because they are something you feel as though you can control.

Growing up, my family was affected every day by mental health because I had loved ones who were raised to feel as though talking about things like depression and anxiety were signs of weakness. And because those issues were internalized, they manifested in other, more destructive ways.

I’m certainly not saying a TV show can solve systemic problems involving the dialogue surrounding mental health, or that it can solve issues in families stemming from a lack of such dialogue. But I do think that having a character like Randall on TV is an important step toward raising awareness and de-stigmatizing oh-so-necessary conversation.

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