5 Times 'This Is Us' Got Mental Health (Mostly) Right


Editor’s note: The following piece contains spoilers from the first two seasons of “This Is Us.”

“This Is Us,” a poignant emotional drama on NBC, follows the lives of the Pearson family as they unfold in their own messy, unabridged humanness. Throughout the first two seasons of the show, viewers watched the characters live their separate but entangled lives. As we got to know them, we witnessed the characters profound affect on one another — creating both heartbreaking and relatable moments that sometimes resonated with our own lives.

Using flashbacks from their childhood intertwined with depictions of their present day lives, viewers learn that despite having both love and support, each character’s life story is also filled with struggles — including mental health struggles.

These depictions of mental illness, grief, addiction and positive and negative coping mechanisms are ones that few other TV shows have successfully portrayed. And although they didn’t get it perfect every time, there are many scenes you may find all too relatable if you struggle with your own mental health.

In honor of the new season of “This Is Us,” which premieres this week, here are five moments from the past two seasons that got mental health (mostly) right:

1. When We Watched Randall Experience a Panic Attack

In season two of “This Is Us,” viewers watch Randall (played by Sterling K. Brown, who recently won a Golden Globe for his role) have a panic attack. Moments leading up to the attack, Randall sits at his work desk and with trembling hands, calls his brother Kevin (played by Justin Hartley). In a shaky voice, Randall tells Kevin he won’t be able to make it to Kevin’s event that night. He says, “I really wish I could be there, it’s just one of those things.” This may sound familiar to you if you’ve had to cancel plans due to a panic attack or simply because you’re having a bad mental health day.

Although Kevin is upset at Randall for ditching out on his important event, he eventually realizes Randall is struggling with something larger than he alluded to, and leaves his event (a play that he has the leading role in) to comfort his brother. The scene closes as Kevin walks into Randall’s office and finds him sitting on the floor in the corner. Kevin proceeds to sit next to Randall, holding him in his arms.

Randall’s panic attack symptoms — blurry vision, tears and feeling frozen (from what it seems) prove that panic attacks don’t always look like hysterics. In this way, it was important to see a “different” kind of panic attack, especially one experienced by a man — who aren’t often portrayed as anxious on screen “I have to say there was something magical about seeing a television character who went through exactly this,” Mighty contributor Monica Drake wrote in a piece called, “Thank You to ‘This Is Us’ for Portraying a Character With Anxiety.” “No stereotypes. No calling him crazy. Just a man who, when things get to be too much, has a breakdown every once in a while. And it’s OK.”

While Randall’s experience rang true for a lot of people, it’s important to remember that this fictional portrayal isn’t always what happens in real life. Mighty contributor Matthew Martin-Ellis explained that while he related to Randall’s experience, he actually thought Kevin’s response was unrealistic. In a piece about the scene, he wrote:

I hate to be the guy who takes issue with a well-meaning (and in many ways progressive) television scene, especially one that sheds light on a character struggling with mental illness. But in many ways I am that character. I have panic attacks… But the fact they are shown as such earth-stopping events met with matching responses from those witnessing them makes the fact that so many of us experience panic attacks on a regular basis all the more discouraging. Because life doesn’t stop to give us time for our panic attacks. Yes, they are that intense and for many of us, they are by no measure infrequent… The responses of allies we see in the realm of fiction seem increasingly idealized and impractical.

2. When We See Kate Struggle With Food and Her Weight

Viewers have watched as Kate (played by Chrissy Metz) struggles with her weight and self-image. In one episode in season 2, Kate lands her first big gig as a singer and feels like she needs to lose weight, so she begins to partake in restrictive behaviors — working out all day, staring at food and not allowing herself to eat it and contemplating purchasing laxatives — all common symptoms of both bulimia and anorexia.

But alhough Kate has her own struggles with food that, in part, stem from her childhood, earlier in the season, she still falls into the trap of stereotyping others who struggle with disordered eating and/or eating disorders.

Kate has been attending Overeater’s Anonymous (OA) meetings, when Madison, the only “thin” woman at the meeting, tells the story of being unable to avoid her favorite appetizers at a party she recently attended. Kate reacts to Madison’s story, shouting:

“Do you know why no one’s defending you? Because you don’t have a problem. The people that come here have problems. Real problems with real issues. What do you come here for, anyways? So you can feel better about yourself because you’re not as screwed up as we are?”

Contributor Darcey Pittman, who struggles with anorexia, was upset by this scene because Kate’s comments felt all too familiar. She wrote, “Kate’s condescending judgment of the anorexic woman because she does not understand she is skinny was out of line. Also, the idealization of the anorexic woman because her skinniness is a coveted attribute was extremely upsetting to me.”

Both this scene, and Kate’s own struggle with restrictive eating, ironically teach us the same lesson — eating disorders and self-image issues don’t have “look,” and anyone, even someone who is struggling themselves, can fall into the trap of thinking they do. In a piece about thinking you’re “too fat” to have an eating disorder, Mighty contributor Sofia Novoa wrote, Not all people who have eating disorders are underweight. And I truly believe that if we, as a society, didn’t have physical standards and stereotypes for eating disorders, maybe just maybe, I would have looked for help sooner.”

3. When We See That Addiction Doesn’t Discriminate

Jack (played by Milo Ventimiglia) struggles with alcoholism, just like his father. Kevin, a successful actor, struggles with opioid addiction. William (Ron Cephas Jones), Randall’s biological father, struggles with drug addiction. Kate struggles with overeating, which studies have shown may be more common for people predisposed to addiction. “This is Us” shows us that no one — no matter your race, gender or age — is immune to addiction.

The shows also shows just how complicated addiction is. In season 2, Kevin undergoes knee surgery and is prescribed opioids — a common class of medication used to manage pain, and one that has been in public discourse recently as rates of opioid addiction continues to rise. When Kevin’s one refill turns into a plea to his doctors for more medication, his relationships, especially the one with his girlfriend, begin to spiral downward. Viewers watch as Kevin becomes solely focused on obtaining medication, and he misses important life events because of it.

While Kevin’s opioid addiction shined light on an important and timely topic, The Mighty’s chronic illness editor Erin Migdol reminded us that many people use opioids to manage pain — and there are other factors that contribute to Kevin’s addiction. She explains:

Kevin’s father struggled with alcohol addiction, and Kevin frequently flashes back to his childhood before taking pills. His sister, Kate (Chrissy Metz), even looks at her father’s ashes, in an urn on her bookshelf, and remarks, “He’s just like you,” referring to Kevin while he’s shown taking pills. Kevin also drinks frequently, enough to lead Sophie to question why he’s downing a beer before a formal event. He’s never quite recovered from his father’s death or losing his football career, and is struggling to deal with his grief.

4. When Randall Shares How He Copes With Anxiety

Living with anxiety usually means living with its symptoms — not ridding yourself of it completely. This is true of Randall, who has struggled with anxiety since childhood and has had to find ways to manage his anxiety.

In a scene with Randall and his foster daughter Deja, played by Lyric Ross, Deja experiences a breakdown, to which Randall responds:

I just wanted to say that I’ve had two nervous breakdowns in my life, one right before Tess was born and one just earlier this year and they happen when I let myself get stressed out and it just builds up inside and then Boom (makes exploding gesture). But one of the things that helps me when I am feeling stressed out is running. I run like everyday — it just helps me clear my mind. So if you ever feel like you want to, I would love to go running with you.

For Randall, running is one way he copes with his anxiety, and even though it doesn’t “cure him,” positive coping mechanisms can be an important part of managing anxiety. When he opens up about this to Deja, he’s normalizing conversations about mental health — and sharing something positive that helps him, without underplaying his (or her) struggle.

5. When Kate Experiences a Miscarriage

In season 2, viewers find out that Kate is pregnant. She is nervous, but excited, and as she starts preparing for the baby’s arrival, ends up having a miscarriage.

In the show, she says, “How could I be this sad? I never even met the baby or held him or her.” But the grief after the loss of a child, no matter how far along, is real, and painful. Mighty contributor Amanda Smith wrote a piece about this episode, and said one of the most emotional moments of the episode was when Kate’s mom, Rebecca, opened up about her own loss.

When Kate questioned how she could be this sad even though she hadn’t even met her baby or even knew if it was a boy or a girl, Rebecca didn’t try to compare their losses. Instead she told her she understood because she had never held Kyle, who died at birth…. When you lose a baby, whether it is an early loss, a late loss, or a stillbirth, you still lose a baby. You are losing all of the hopes and dreams you had for that baby.

When one doctor suggests that Kate and her partner Toby (played Chris Sullivan) just “move on,” it shows not everyone understands the grief that comes with a miscarriage — even if they’re in the medical field. Despite Kate’s fresh trauma, though, her mother serves as a reminder that even though loss changes you, there can still be hope and purpose after loss.

“This Is Us” airs at 9:00 p.m. on Tuesdays on NBC.

Lead photo via “This Is Us” Facebook page


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