This Is Us Having Panic Attacks

​By Mike McMahan, LPC
 
When TV gets something mental-health related right, it is worth celebrating. And, last week, This Is Us got it right.
 
Part of being in any profession that is ever depicted on television or in movies is cringing at the inaccuracy of what is being shown. Entertainment is generally not about education; even documentaries tend to show clips and feature conversation that fits the narrative the filmmakers are shaping or the message they are trying to impart, any broader truth be damned. This often creates a situation in which professions are portrayed in a very broad or even inaccurate manner. Whatever the characters need to do to advance the story is what writers and directors do. Who cares if a scientist would never remotely act the way he or she is depicted.
 
It sometimes seems that this applies in a particularly strong fashion to the field of psychology. Perhaps it is the mystique that surrounds mental illness. Or perhaps I’m just biased. But the prevalence of, for example, “multiple personality disorder” (Dissociative Identity Disorder) has been totally blown out of proportion by its use as a plot device in movies and TV. And, hey, I get it. The disorder presents an opportunity for a huge twist moment and is shocking for most people to even consider. “What if I had a secret life and an entirely different personality that I don’t know about?” The thing is you don’t. And neither does anyone else you know, statistically speaking. This disorder is extraordinarily rare. Most clinicians will go their entire career and never encounter this illness. While schizophrenia is more common than DID, entertainment-driven stereotypes also confuse the issue of what schizophrenia actually is. People with schizophrenia are generally not violent or dangerous and they most definitely don’t have “multiple personalities.” They aren’t supervillains hatching sinister plots. Many of them have extraordinarily challenging lives and very sad stories.
 
Anxiety disorders are much more understandable than schizophrenia or dissociative identity disorder, and, of course, more common. I’ve never watched This Is Us, though it’s certainly been in entertainment headlines. Maybe I should, as I was struck to learn of this clip that showed a character, Randall, reacting to a call from his brother, Kevin, who was having a panic attack. These things are very scary, as Kevin’s reaction shows. When Randall leaves his performance to help Kevin, I found it pretty moving. Most people wouldn’t have done this, but Randall’s recognition and support was touching. Panic attacks are not something that you can just “get over” and people can’t just “relax.” In addition to the racing thoughts and feelings of imminent doom, panic attacks may be accompanied by physical symptoms such as accelerated heartbeat, sweating or shortness of breath. I’m aware of a psychologist who includes in her regimen of treatment for panic attacks at the VA an exercise in which she asks patients to drink 5+ shots of espresso. She then helps them learn how to work with their mind to help their body to control these physical symptoms of panic. If you’ve ever drank 5+ espresso shots, you can imagine the challenge. And if this doesn’t get your heart pumping, well, tolerance is a real thing and caffeine is a helluva drug!
 
If you experience these symptoms, by all means speak to a mental health professional, as treatments (including medication and/or therapy) are highly effective. And if you have a friend or loved one experiencing a panic attack, please don’t minimize it. They are terrifying.
 
 
Mike McMahan, LPC is a psychotherapist based in San Antonio, Tx.