It's unusual for television to handle mental health issues realistically and compassionately without getting preachy.
Many shows emphasize sensationalism over substance, exaggerating symptoms or reinforcing negative myths that increase stigma.
But This Is Us always handles mental health issues sensitively, and This Is Us Season 4 Episode 5 was no exception.
Tess' panic attack could have been played for ratings, but instead, it happened off-screen, and the real story was about everyone's reaction to it.
Randall was overly eager to help, which made things worse. He understood what Tess was going through, but his over insistence on talking about it probably came from guilt.
Tess' outburst in response made sense, but I had to wonder if there was something more to it.
Did she just want not to have panic attacks like Randall, or was there some deeper meaning to her wish that she wasn't anything like him?
The whole thing couldn't have come at a worse time for Randall. The councilman he was meeting with, like so many people who don't suffer from mental illness themselves, assumed Randall was blowing him off again.
It looks like trouble for Randall at work, and his difficulty navigating both work and family issues was making Randall's knee bounce up and down just as badly as it did at the dinner party when he was in college.
Randall: Hey Dej! What kind of cereal do you want?
Deja: You think cereal will make me forget that you treat me like a child who can't decide who to date?
And it's not just Tess he has to worry about, either. He and Beth put their feet down about Malik off-screen, and now, Deja's mad at Randall, too.
Randall is definitely headed for a fall, and his refusal to seek help isn't a good sign.
It's realistic, though.
Many people with anxiety, depression, and other mental health issues want to believe they can handle everything on their own ... until they can't.
And statistically, men are more reluctant to seek therapy than women, and many African Americans have cultural taboos against therapy as well as fear discrimination and racism in the therapy process.
Hopefully, those issues will be explored more in-depth as Tess begins therapy and Randall continues resisting it.
Growing up, I never shared genetic traits with anyone I knew. And when we had kids I couldn't wait to see what they got from me. Would they have cute ears, roll their tongues? Anxiety and panic attacks are the things about me I like the least, and I passed it on to her. I hate that I gave this to her.Randall
The genetic aspect of mental illnesses such as anxiety disorders is also something that isn't always talked about properly.
Both Randall and William hated that they passed their anxiety onto their children, and Beth needed to address that before Tess' anger at Randall and herself for the disorder went too far.
Tess' anxiety is also bound up with her difficulties with dealing with her sexual orientation.
I like that she's depicted as a normal teen who has extra stress because she's a not-out-to-everyone lesbian. Her sexual orientation isn't at the forefront of every story, but instead, it is just one thing out of many that she deals with regularly.
STOP! I have been planning this for weeks so that it would be perfect. Because this is where we live now, and this is where we move forward, where we talk over napkins and placemats and eat Cornish hens. And it doesn't matter that I couldn't find my pot and I burned the Cornish hens or that all I got of your wedding was Polaroids, because I am doing my best and this is what we have to work towards. So pull yourselves together, pretend you like burnt, raw food and get your whiny little asses back in those seats and enjoy my damn dinner!Rebecca
Past and present blended together nicely in this story. Not only did college-age Randall suffer from anxiety too, but Rebecca was pressuring herself to make this dinner party perfect to try to help bring her fragmented family back together after Jack's death.
Rebecca's story about Jack and the bird reflected the theme at the heart of This Is Us.
The Pearsons are perfectly imperfect. Their family is messy and they all try too damn hard to make things more perfect than they're capable of being, especially during hard times.
But in the end, they are a family, and they're there for each other as best as they can be.
The contrast between newlywed Kevin and adult Kevin was interesting.
Kevin is still prone to spontaneity. He randomly bought an RV and moved in next door to Nicky and his decision to confront Cassidy's husband was emotion-based and impulsive.
Cassidy's husband went for the stereotypical warning to stay away from his wife, which will probably work as well as Randall telling Deja not to spend time with Malik.
Anyway, the PTSD stories were well done as always.
Other than the irritating warning to Kevin to stay away from Cassidy, her husband's speech was powerful and important.
PTSD and other mental illnesses take a toll not only on the person who suffers from them but also on the people that love them.
Cassidy's husband pointed that out, and to an extent, Kevin's relationship with Nicky reinforces that theme.
You know what would be really nice? If I could drink 10 beers just to get through this. Just kidding. I prefer whiskey.Nicky
Nicky couldn't deal with being at the hockey game. Being around other veterans and people drinking alcohol was a bad combination. To his credit, this time he realized it and got the hell out of there.
Kevin seems to always be chasing Nicky around, but it finally paid off when Nicky told him that Jack wasn't the only one who cut slices of ice cream.
That felt like a turning point, like Nicky finally accepts Kevin in his life to some degree. Hopefully, Kevin can relax and stop trying too hard to forge a relationship with Nicky now.
There wasn't too much baby Jack stuff on This Is Us Season 4 Episode 5, but there WAS a new mystery.
What happened between Kate and Mark, and how did it impact Kate?
And will Mark show up again in the present? Not that Toby and Kate need any more problems, but that could be interesting!
Your turn, This is Us fanatics
Share with us what you thought about the way This Is Us handled Tess' anxiety attack, your best guesses on what happened between Kate and Mark, and your thoughts on everything else that happened in this episode.
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This Is Us continues to air on NBC on Tuesdays at 9 PM EST/PST.
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