Princess Kate’s brother has revealed that his sister left him feeling “overwhelmed” when she accompanied him to an emotional therapy session in 2018 after a period of depression left him considering suicide.

James Middleton has provided a raw and unfiltered account of his mental health struggles in extracts from his , which have been published by the Daily Mail. This includes his personal journey to being diagnosed with clinical depression and attention deficit disorder in 2017.

Middleton wrote that after a challenging period his already fragile mental state deteriorated in 2016, leading to breakdowns in his personal relationships and the pushing away of family members.

At a point in 2017, he told readers he became so despondent that he was consumed with thoughts of how to end his life.

“Walking in front of a train might be quickest. Or disappearing into remote woodland and cutting my wrists. These suicidal thoughts possess me,” he wrote.

After this, he sought professional medical help and cognitive behavioral therapy.

In January 2018 he said he invited his sisters—Kate and Pippa Matthews—to accompany him to a session, which they both accepted.

“Catherine and Pippa come on board, and they understand. This is the first time they have become aware of the extent of my struggles and the fact that they are here with me, wanting so much to help me, makes me cry,” he revealed of the emotional undertaking.

“I did not tell even Dr Pereira how closely my thoughts had wandered towards suicide. It is he who, with my ­consent, now talks to my sisters, simply because I find it so hard to articulate what has been going on in my mind,” he said.

Middleton said that his sister’s charity work within the mental health field helped her understanding of his experiences.

“They listen and learn,” he wrote of his sisters during the therapy session. “Catherine has already done a lot of work through her mental health ­initiative Heads Together, and she asks Dr Pereira some pertinent questions. She understands so much. I’m overwhelmed.”

This is the first time that Middleton has spoken in any depth about the content of the session with his sisters, having first revealed that they accompanied him to meet his therapist in an essay published by the Sunday Times in 2023.

In his memoir, named in honor of his late dog Ella, whom he credits with helping him through his darkest days, Middleton explores how his personal journey to understanding his mental health has helped him build his life in a positive direction. He has become a vocal mental health advocate and animal welfare supporter in recent years.

Kate is known to be very close to her family, with also forming tight bonds with his in-laws.

Pippa and James were guests not only at the royal wedding in 2011, but also major subsequent events connected with the monarchy. Most recently they were present with their parents at the coronation of King Charles and Queen Camilla in 2023.

In 2021, Middleton married French-born financier Alizée Thevenet. Together they have a son, Inigo, who was born in 2023.

If you or someone you know is considering suicide, please contact the 988 Suicide and Crisis Lifeline by dialing 988, text “988” to the Crisis Text Line at 741741 or go to .

“Meet Ella: The Dog Who Saved My Life” by James Middleton is published in the United States by Pegasus Books and released on September 26.

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