James Middleton is opening up about his battle with depression and anxiety.
After being thrust into the spotlight when his sister, Kate, started dating Prince William in 2003, James recently admitted in an interview it put him under pressure.
Kate's brother tells British magazine Tatler that he was crippled by the illness.
"It's what keeps you in bed, while anxiety makes you feel guilty for being there," Middleton told the magazine.
Middleton acknowledges that he has a charmed existence, saying when the depression struck, he asked himself "what do I have to be depressed about?"
"I've been so lucky with my upbringing, I had all the things I wanted, said Middleton. "It's not that I wanted more, but there was something that wasn't always there... And the more I ignored it, the more it was taking over."
In the interview, Middleton says that when his sister married the future King of England he was suddenly thrust into the public spotlight and struggled with the public scrutiny.
"Suddenly, and very publicly, I was being judged about whether I was a success or a failure," he said. "That does put pressure on you. Because in my mind I'm doing this irrespective of my family and events that have happened."
Middleton says his crisis point came in late 2017 and he sought professional help.
In January of this year, Middleton wrote very candidly in the Daily Mail about his mental health problems.
He said then that he came forward to tell his story to help remove the stigma surrounding mental health - a cause close to his sister's heart.
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In the interview, Middleton says that therapy has helped him.
"I am happy - I feel like James Middleton again. I feel like I was when I was 13, excited about life," he said. "I feel like myself again and I couldn't ask for more."
Kate Middleton's brother, James, opens up about battle with depression, anxiety brought on by fame