Family members don’t like each other, Thanksgiving is a nightmare, and life is a fleeting state of being that we inevitably forget–even for America’s favorite adoptive family, the Pearsons, on NBC’s This Is Us.

Season 4’s midseason finale, “So Long, Marianne,” saw Randall Pearson (Sterling K. Brown) struggling to enjoy his favorite holiday, Thanksgiving, while the Big Three’s estranged Uncle Nicky felt uncomfortable sharing a family holiday with the Pearsons, and Kate finds a message from another woman on her husband, Toby’s, phone. In other words, they had a typical American Thanksgiving.

So far, season 4 has masterfully tackled the nuances and discomforts of interracial adoption (thanks to a diverse writing team with people of color taking the lead on racial issues), and the show defers to the real experiences of servicemembers and veterans who’ve suffered PTSD to depict Uncle Nicky (Griffin Dunne) and Cassidy Sharp’s (Jennifer Morrision) respective traumas. Now This Is Us is producing one of TV’s most humane and empathetic depictions of dementia–or so we hope.

At the center of the season’s trifold dramas, Rebecca Pearson (Mandy Moore) is clearly experiencing symptoms of dementia. Thanksgiving Day finds Randall and Rebecca already in the midst of a disagreement over the seriousness of her forgetful “senior moments.” Tension piques as Rebecca leaves the house, loses her phone, and becomes lost in Philadelphia while suffering memory lapses that necessitate the police escorting her home. Later, she shamefully confesses to Randall, “I was halfway through the trailer of Cats when I couldn’t remember what movie I was going to see. I think I need to see a doctor.”‘

Shortly after the episode aired, Moore took to Instagram to post a screenshot of the poignant moment between mother and son: “Though he’s been aching for her to admit it, hearing her say the words was absolutely devastating. And while the road ahead is unknown, she has the very best family by her side. #ThisIsUs“

But the exact cause of Rebecca’s cognitive deterioration isn’t clear. The show’s executive producer, Isaac Aptaker, confirmed to Entertainment that they wanted to tell a “story about Alzheimer’s or dementia.” But, mirroring the drawn-out frustrations and uncertainty that accompany medical treatment in reality, they’re not giving away answers on the show. “We’re not giving an exact medical diagnosis just yet,” Aptaker said, adding that “so many people in the writers’ room have dealt with parents with various forms of, call it dementia, Alzheimer’s, what you will, and we felt like it’s a story that we haven’t seen a ton on network television.”

Moore, aside from continuously impressing viewers with her ability to age-slide her character from her 20s all the way up her 80s, has been more forthcoming. While fan theories insist that Rebecca is experiencing the onset of Alzheimer’s disease, Moore has outright denied the claim. “I love how people are sleuths,” she told Glamour earlier this year. “I love that! That’s a good theory. Not true, but I like it.”

Even if the Pearson matriarch isn’t suffering from Alzheimer’s, many fans identified with the sympathetic and all-too-real confusion, frustration, and mood swings of the beloved mother figure. Many praised Moore’s portrayal of Rebecca’s memory lapses, with many citing their own loved ones’ struggles: “This episode hit me hard,” one comment reads.”…dealing with my father having Alzheimer’s. Still bawling my eyes out.” Another commenter replies, “same! My dad has vascular dementia! This disease is so horrible. I haven’t watched the episode yet but just from the preview where rebecca is just standing there confused and not knowing where she was just broke my heart. I’ve see[n] my dad do this so many times. Now he can barely walk and is losing weight. He doesn’t know any of us kids.”

The Future Is Changing for the Pearsons – This Is Usyoutu.be

Above all, Rebecca’s fate cements the show’s ability to depict the heartbreak and decline of loved ones and even family bonds, as the midseason finale ended with a signature twist: Rebecca’s struggles were actually taking place nine months into the future, on the Pearson triplet’s 40th birthday. The writers filled the last few minutes of the episode with scintillating teasers, from foreboding to joyful: Kevin seems to have fulfilled his goal of settling down, alluding to his “pregnant fiance’s” morning sickness; but he reminds Rebecca that he and Randall are no longer speaking; and Toby is suspiciously absent from his wife’s birthday party, suggesting that he and Kate have parted ways.

According to the show’s producers, we won’t have to wait too long to find out what’s happening to Rebecca. “So much of this show is about memory and about looking back,” Aptaker said. “So the idea that one of our characters would be faced with this incredibly scary illness where you begin to lose that and that begins to fade away felt very in keeping with the themes of the show.” Another one of the show’s themes is its ability to make 12 million viewers cry, in sync, every Tuesday at 9 p.m EST. The only tradition more American than Thanksgiving is treating TV as group therapy, and This Is Us will resume sessions with us on January 14, 2020.