Carole Middleton 'did not understand James Middleton's mental health problems'

James opened up in the book about being diagnosed with clinical depression as a young adult and the reaction from his family members.

The father-of-one described having both clinical depression and ADD (Attention Deficit Disorder), writing that "for years, I’ve felt misunderstood, that no one quite gets me".

His doctor, Dr Pereira, gave James a book on ADD and told him to "highlight the bits that apply to you".

James admitted the whole book ended up being highlighted as he felt "the entire thing has been written just for me".

He added that he hoped the book would help his parents, Carole and Michael Middleton, better understand his mental health problems.

James wrote: "I am so comforted by the book that I buy copies for all the family: Mum and Dad, Catherine and William, Pippa and James.

"I hope the book will help their understanding of me. Certainly it helps me know why I start every job thinking I am doomed to fail; why I’ve never learned to follow instructions; why some people write me off as lazy, stupid, a mess.

"It is often the case that your family, who love and know you best, are also the most critical of you.

"Mum and Dad found it difficult to talk to me about my mental health, because they felt they knew me better than I did.

"Their intentions were kind. They were hugely supportive. But some of their suggestions were not constructive.

"They were resistant to therapy. And their biggest worry was that I would become dependent on antidepressant drugs.

"I, in turn, was defensive, annoyed. I’d already made up my mind that I didn’t want to take prescription drugs for my depression. My parents’ involvement felt like needless interference.

"They were uncomfortable with the fact that I’d been labelled ‘clinically depressed’. To people of their generation, I can understand why it was concerning. Society is only just starting to break through the stigma."

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James added that his sisters, Princess Kate and Pippa Matthews, were both incredibly supportive of their younger brother and helped relay his problems to their parents.

He continued: "Catherine and Pippa understood, though.

"They helped to convey what was going on to our parents because my sisters had been exposed to similar experiences through friends who’d had depression."

Anyone who is in emotional distress, struggling to cope or at risk of suicide can call the Samaritans anonymously for free from a UK phone on 116 123 or go to samaritans.org.