‘This Is Us’: ‘This Is Us’: Is the Midseason Premiere Shocking Twist a Symptom of Randall’s Mental Health Condition?

The highly anticipated midseason premiere of This Is Us finally debuted, but fans are on edge. The last few seconds of the show were terrifying. Fans were screaming, much like Sterling K. Brown was, although he knew what the plot twist was. Let’s take a look at why the plot twist may not be what it seems.

Sterling K. Brown
Sterling K. Brown | Ron Batzdorff/NBC/NBCU Photo Bank via Getty Images

[Warning: This Is Us Season 4 spoilers ahead]

What happened with Randall in the ‘This Is Us’ midseason premiere?

The series started the premiere with several typical Randall (Brown) things. He flew across the country—from Philadelphia to Los Angeles—to be with his mother, Rebecca (Mandy Moore), at a doctor’s appointment.

Dr. Whittaker thanks Randall for the 47 emails he wrote to get his mother seen so quickly. We do receive pretty devastating news about Rebecca; however, it was reasonably predictable.

“You have a mild cognitive impairment,” the doctor tells Rebecca, Randall, and Miguel (Jon Huertas). It means that the test revealed some changes in your understanding of things, and that concerns me.”

It is almost a relief for Randall. His mother is experiencing relatively typical symptoms of aging. The doctor indicates that it could get worse, but it also could just remain the same.

There are a few adorable moments between Rebecca and Randall as a baby. In the present-day, Rebecca tells Randall about the time she spent with just him in the mornings before his brother and sister woke up. It all gives us a bit of a false sense of hope.

The last ten-seconds of ‘This Is Us’ are terrifying

Randall flies home to his family and greets his wife, Beth (Susan Kelechi-Watson). He pops back downstairs, presumably to check that the doors are locked or grab a glass of water. Then he sees an intruder with a knife in his hand. Cue the screaming from viewers at home.

The scenes from next week give us a small indication of what is about to go down next.

“You are not getting past me,” Randall says to the weapon-wielding man in his living room.

We also watch several scenes of Randall as a child who was afraid of monsters. We find out that he has strange, terrifying dreams of someone breaking into his room or his house at nighttime. His deepest, darkest fear is coming true.

Is the home intruder in Randall’s head, or is it real?

“Maybe it’s all a symptom of his own psyche,” wrote one Reddit user. “That is still building in the background, correct? We just haven’t talked about it lately.”

Randall struggles with anxiety, and is under a lot of stress right now with his position as City Councilman.

“That line about ‘monsters’ makes me think he’s hallucinating from stress,” added another Redditor referring to the promo for next week.

Could the monster be a hallucination?

“I think the intruder may be imaginary and have to do with his anxiety, which is on set by Rebecca’s failing health,” wrote yet another fan in agreement.

We will have to wait and see what happens next Tuesday at 9 p.m. ET when This Is Us returns to NBC.