NBC’s This is Us: Randall’s Not Okay

When I first started watching This Is Us, I immediately fell in love with the relatable and compelling storyline: the childhood, the adolescence, and the adulthood of a very special family that almost seems too perfect. That is until you realize that, from the very first moment, the family is far from “perfect,” making the show that much more likable. The show integrates taboo topics, including grief, obesity, relationship issues, and so much more into the storyline, making the characters much more realistic.

And then came the topic that the media is generally cautious about: mental health. Yes, the show may sometimes inaccurately portray mental health issues, specifically that of Toby’s depression. But when I came across these episodes, I personally wasn’t thinking of the technical facts that were off. Rather, I was in shock, awe, and admiration of the show’s boldness to talk about mental health in such a raw, relatable way. I believe it is important to applaud This Is Us by focusing on the positive accurate ways they advance the mental health conversation, specifically in the case of Randall.

Randall Pearson is the adopted sibling of Kevin and Kate. Due to his intellect, compassion, and perfection, he is often considered the “favorite child”. Randall has a strong type A personality, especially when it comes to school and work. His obsession for perfection often leads to stressful moments that could be quite overwhelming. This is how anxiety creeps in.

Randall’s Anxiety

Our first explicit exposure to Randall’s anxiety is in Season 1 Episode 15. We see an instance where Randall gets in trouble at school. Too nervous about how his parents would react, Randall has his first anxiety attack. The only person who knows about this is his brother Kevin, who isn’t much of a help to him at that moment. Present-day Kevin, however, is much more sensitive, and helps Randall cope through a breakdown that occurs in his adulthood due to work and family stress.

In Season 4 Episode 5, Randall finds out that his daughter has anxiety too, and, as he later finds out, so did his father. Statistically, this isn’t surprising, as according to the DSM 5 (the Diagnostic and Statistical Manual of Mental Disorders), “One-third of the risk of experiencing generalized anxiety disorder is genetic…” (Goldberg et al. 2009; Hettema et al. 2006). Throughout the show, viewers continue to see patterns of Randall’s refusal of getting help for himself, which could potentially send a dangerous message to his daughter.

The peak of Randall’s anxiety occurs in Season 4 Episode 11. Randall has a lot on his plate: work is stressful, his mother’s health is deteriorating, and a burglar brakes into his house. 

The show then pans to the past, when Randall was in college. In this scene, Randall freaks out during a fire drill, most likely due to the fact that his own house had had a fire, in which his father died. In both of these anxiety-ridden instances, we are informed that Randall has a history of having nightmares and being unable to sleep. This restlessness is also common among those with anxiety, as the DSM 5 states: “…the individual experiences physical symptoms, including restlessness or feeling keyed up or on edge; being easily fatigued; difficulty concentrating or mind going blank; irritability; muscle tension; and sleep disturbance.”

From his college years to his adult years, Randall has been offered the same piece of advice from friends and family alike: to go to therapy. Each and every time, however, he turns it down. He claims that he’s self-aware, knows how to deal with it, and uses exercise to cope–he’s fine. This is quite a dangerous response when it comes to mental health.

Asking for Help – Randall and Me

Regarding my own anxiety, I went through a similar pattern as Randall. I felt like I was self-aware enough to be “my own therapist,” dealt with it on my own, and felt that therapy and medication were signs of weakness. I fooled myself into thinking that I had the same capabilities as a mental health expert. Thank God, I eventually got the help I needed, but it took a lot of vulnerability and submission.

At the end of the episode, Randall has a breakdown in the bathroom and calls Kevin. He says the bravest words that one can ever admit: “I’m not okay”. I think the most important lesson that we can learn from here is the first step of admittance: I’m not okay. It takes a tremendous amount of vulnerability and humility to acknowledge that.

Anxiety in Perspective

According to the ADAA, 40 million adults (above the age of 18) in the U.S. suffer from anxiety every year–and that’s not even including teenagers! The wildest statistic, though, is that only 36.9% of those with anxiety actually seek treatment. It’s absolutely mind-boggling–why don’t more people get treatment? I think it comes down to three key reasons:

  1. Embarrassment
  2. Fear of opening up to others
  3. Lack of education about anxiety (and other mental health-related issues)

Thank you, This is Us, for showing us that all three are possible to overcome, and being a vehicle to teach about mental illness.

DSM 5 Citation: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.


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Tzivia Appleman
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