Speaking out. Duchess Kate and Pippa Middleton‘s younger brother, James Middleton, revealed that the Duchess of Cambridge and their family attended therapy sessions with him during his battle with depression.
The British businessman told The Telegraph that he spent nearly a year in cognitive behavioral therapy, often with his family, after he went to a private psychiatric hospital for a consultation.
“That was so important because that helped them understand me and how my mind was working,” he explained in an interview published on Friday, October 11. “And I think the way the therapy helped me was that I didn’t need my family to say, ‘What can we do?’ The only thing they could do was just come to some of the therapy sessions to start to understand.”
James, 32, added that he “couldn’t do anything” during his bouts of depression — including speak to his parents, Carol and Michael Middleton, and sisters.
“I couldn’t sleep, I couldn’t read a book, I couldn’t watch a film, I couldn’t eat,” he said. “The fact is, no matter what experience someone has, your family members are the hardest people [to talk to]. … You also have a very different way of interacting with your family than you do with your friends. I’m the youngest child, so I think that’s normal. And they are so tuned into you that they can see what other people can’t.”
The 32-year-old, who recently proposed to his girlfriend, French financial analyst Alizee Thevenet, expanded on his mental health struggles in an Instagram post for World Mental Health Day on Thursday, October 10. James shared that his therapy dog, Ella, helped him manage the difficult times.
“This is Ella & these are the eyes which helped me get through the insufferable darkness,” he wrote alongside a photo of the black spaniel. “The gentle touch of your wet nose and a loving lick was enough to make me feel brave. I will forever be in your debt. Thank you Ella.”

While James is “conscious” that he has not “got rid” of his illness, he is “very pleased that I went through it, because of who I am on the other side.”
“It was a dark and miserable place to be, but the fact is there is hope at the end. It requires effort and energy, but the other side is… the grass can be greener than it was before,” he shared. “For me, now, there’s a feeling that I can take on anything, in the nicest possible way. Not in a [combative] way. Because if I can talk about my mental health and the things I am passionate about and the way I truly feel … well, then, I’m not pretending to be anyone. This is who I am.”
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