For years, the rising generation of the royal family—specifically Duchess of Cambridge Kate Middleton, Prince William, and Prince Harry—has worked through their Heads Together foundation to change the conversation around mental illness and combat stigma around it, especially within the United Kingdom. Prince Harry, in particular, has been especially vocal about his own struggles, opening up about being “close to a complete breakdown on numerous occasions.” Now, Kate’s brother is contributing to the conversation: In a new op-ed for the Daily Mail, James Middleton—who has historically remained quiet on all matters concerning his family—openly applauds his royal sister and brothers-in-law for their work as he opened up for the first time about his own years-long battle with anxiety and depression.

In the essay, Kate’s younger brother describes the challenges of living with severe dyslexia and Attention Deficit Disorder (ADD) and how that morphed into an exhausting struggle with anxiety and depression later in life: “Each night sleep eluded me,” he writes. “During the day I’d drag myself up and go to work, then just stare with glazed eyes at my computer screen, willing the hours to tick by so I could drive home again. Debilitating inertia gripped me. I couldn’t respond to the simplest message so I didn’t open my emails. I couldn’t communicate, even with those I loved best: my family and close friends.”

Middleton goes on to acknowledge that although he’s privileged, that doesn’t make him “immune” to issues with mental health. “I know I’m richly blessed and live a privileged life. But it did not make me immune to depression,” he says. “It is tricky to describe the condition. It is not merely sadness. It is an illness, a cancer of the mind.”

According to the World Health Organization, depression is an extremely common mental health disorder affecting more than 300 million people of all ages worldwide. But despite its wide reach, depression—as with many other mental health conditions—is often culturally stigmatized. In the UK, open discussions around depression and other mental health issues are still largely more taboo than not—for men in particular—making Middleton’s essay especially important. “For many men, opening up about their feelings is the biggest social taboo,” wrote Chris Hemmings in 2016 for the Independent, a British newspaper. Instead, he writes, “[we] bury our heads in the sand—or bottle, to be more accurate, as alcoholism rates for men in the UK are three times that of women.” A report from the UK’s Mental Health Foundation places suicide—which, the report reads is “associated with depressive disorders across the globe”—as the leading cause of death in the UK among people 20 to 34 years old, with more than three times as many men as women dying as a result of suicide.

Despite his sister’s advocacy and the fact that the Middleton family had become “desperately worried” about his well-being, James writes that he found it difficult to open up to them at first, explaining that often with depression, “those who are closest to you are the hardest to speak to.” Ultimately, it was the royals’ years-long advocacy for openness around mental health that helped James come forward with his own story.

“I feel compelled to talk about it openly because this is precisely what my brother-in-law Prince William, my sister Catherine and Prince Harry are advocating through their mental health charity Heads Together,” he says.

“They believe we can only tackle the stigma associated with mental illness if we have the courage to change the national conversation, to expel its negative associations,” he writes. “So it wouldn’t be honest to suppress my story. I want to speak out, and they are my motivation for doing so.”

Ultimately, Middleton hopes that by opening up about his struggle with anxiety and depression, he’ll encourage others to do the same. Props to him for speaking out—and continuing to unravel the stigma.

If you or someone you know is struggling with depression, visit Mental Health America or the Anxiety and Depression Association of America for access to resources, help, and support.

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