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The Torment of My Secret Illness by James Middleton

Each night sleep eluded me. A cacophony of imaginary noises rang in my head. It felt as if ten different radio stations were competing for airtime and the din was ceaseless and wearying.

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.

Their anxious texts grew more insistent by the day, yet they went unanswered as I sank progressively deeper into a morass of despair.

All colour and emotion had leached out of my world and everything was grey and monotone.

I know I’m richly blessed and live a privileged life. But it did not make me immune to depression. It is tricky to describe the condition. It is not merely sadness. It is an illness, a cancer of the mind.

It’s not a feeling but an absence of feelings. You exist without purpose or direction. I couldn’t feel joy, excitement or anticipation – only heart-thudding anxiety propelled me out of bed in the morning. I didn’t actually contemplate suicide — but I didn’t want to live in the state of mind I was in either.

I also felt misunderstood; a complete failure. I wouldn’t wish the sense of worthlessness and desperation, the isolation and loneliness on my worst enemy. I felt as if I was going crazy.

So just over a year ago — in December 2017 — after enduring a progressive deterioration in my mental health over 12 months, I packed my dogs into my car and, telling no one where I was going, drove to a wild part of the Lake District I’ve loved since I was a child.

There I swam in an icy Coniston Water, took solitary walks on snow-capped mountains and stayed alone in a remote cottage for a few days, eating from packets and trying to still the tumult in my mind.

In the days before, I’d finally confronted the fact that I couldn’t cope any longer, that I wasn’t all right; that I desperately needed help. And this recognition led to a sort of calm: I knew if I accepted help there would be hope. It was a tiny spark of light in the darkness.

You may wonder why I have chosen to speak now about the clinical depression that first hit me at the end of 2016. There are two reasons.

Firstly, I feel — although I’d never say I am cured of it — that now I understand it and, with professional help, have worked out strategies for coping. Today, I feel a new sense of purpose and zest for life.

Secondly — and perhaps most importantly — 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.

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. So it wouldn’t be honest to suppress my story. I want to speak out, and they are my motivation for doing so.

Depression is only a small part of the complex jigsaw that is me. Since childhood, I’ve known I was severely dyslexic — both letters and numbers still jump and blur on the page in front of me and some days I have difficulty spelling even the simplest words.

But it was only when, a year ago, I was also diagnosed with Attention Deficit Disorder (ADD) that all the quirks and foibles of my character started to make sense.

ADD, an adult variant of Attention Deficit Hyperactivity Disorder, which is associated with children, produces a range of symptoms.

And it was a revelation when I was told I had it. It explained so much. It is the reason I have trouble focusing; why my mind wanders off into extravagant daydreams; why simple tasks such as making my bed assume the same enormity as filing my tax return.

ADD explains other things, too: why I’m restless, energetic and impulsive; why I start tasks but can’t complete them; why sometimes I seem impatient and don’t listen because my mind is galloping off on some flight of fancy.

However, I also see my ADD as a gift: it accounts for my creativity and emotional intensity. It means that I come up with fantastic, original ideas — but it also explains why I have had difficulties with the minutiae of running a business.

But now I’m starting to impose order on my life. I write a list of ten things I want to do each day. If I know I really need to concentrate on a task, I might take medication prescribed by my doctor to control my symptoms.

If that is the present, then it also explains my past. From as early as I can remember I knew my brain was wired differently from most people’s. At my prep school — St Andrew’s, in Pangbourne, Berkshire — I was very slow in reading and maths, but also dextrous and practical.

From a young age I was curious about taking things apart and building them again. I made mini steam toys. I assembled IKEA flat packs without the instructions, intuiting exactly how the pieces fitted together, just from a drawing of the finished product.

But when I was called on to read out loud from a book in front of the class, letters would jump around, strange words would form; I’d read a different story from everyone else. I was terrified of ridicule and ashamed of being a slow learner. I hid my beginner’s reading book inside a more advanced one so none of my classmates knew I was so far behind them.

I also began to feel the pressure of not being able to write properly. Words became indecipherable squiggles because I didn’t know how to spell them (I often still don’t). And I became isolated by my dyslexia because I’d lose out on extra-curricular activities while I was catching up on academic work. Permanently, I lagged behind.

Now, of course, I know it was ADD that prevented me from focusing on the smallest tasks: even brushing my teeth and getting dressed seemed insurmountable, pointless exercises.

But mechanical and practical work thrilled me. I stripped down and rebuilt old tractors and Land Rovers, remembering, down to the tiniest part, what went where.

When I moved on to senior school, following my sisters to board at Marlborough College, Wiltshire, I was horribly homesick.

Catherine had already left for university by the time I got there, but having Pippa around was a comfort. Even so, I didn’t fit in.

Because of my dyslexia I was given longer to finish exams, which was a waste of time: it just meant I had more time to realise I couldn’t answer the questions.

I was coached and cajoled through my GCSEs, but A-levels proved impossibly difficult.

My grades were abysmal so I took them again — and again at sixth form college, finally emerging with results that allowed me to scrape into Edinburgh University to study environmental resources management.

A month in, I thought: ‘What am I doing here?’ I couldn’t cope with independent studying and wanted to quit — and after a year I did.

I’m not criticising the system. But because I didn’t know my brain worked differently — and neither did my parents — I couldn’t find a way of steering round my ADD. If diagnosis and help had happened sooner, I’d have found life so much easier.

As it was, I felt unable to fit in with society’s expectations of me.

I knew, too, I could only ever work for myself — I couldn’t have coped with the constraints and routine of being employed — so I set up two businesses by the time I was 20: one supplying cake-making kits to home bakers, then another, Nice Cakes, making personalised photo cakes.

They’ve closed now, but I’ve learned from them and progressed. Today, I have my personalised greeting card company, Boomf, which I’m very proud of, and I’m excited about future ventures.

It’s run by a fantastic team who have supported me through my dark times and encouraged my creative streak.

But it’s hard work setting up in business — even without ADD and dyslexia, it’s like pushing water uphill. Beset by both (though the ADD was not yet diagnosed) I found it hard to cope. Self-doubt eroded my confidence; nothing made me happy, passionate or excited any more.

At the end of 2016 my heart started beating so fast it felt like an engine revving at full tilt.

I knew something was wrong, so I phoned my GP and had tests which revealed arrhythmia — irregular heartbeat — caused by stress and anxiety. After a short time on medication the symptoms subsided. But, against my doctor’s advice, I did nothing about treating the root cause of the problem.

The best part of 2017 passed in a fog. I barely functioned, stopped talking to my friends, went through the motions of living and working but achieved nothing at all.

I came very close to shutting my company down. And still my heart was thudding as if it was straining to leap out of my body.

Yet I tried to convince myself I was fine. I put it all down to the stress of work. Meanwhile, my family — worried to distraction — could not break through the barrier of my silence.

I wanted to stay in bed all day, and it was only intense anxiety — a feeling like someone screaming in my face — that propelled me up in the morning.

So at the end of that year, after months of sleeplessness, anxiety and inertia, I realised I’d have to consult my doctor again. When I rang her I felt as if I was trying to hold in a waterfall of emotion. I struggled to get the words out and I was close to sobbing.

‘I’m not OK. I need some help,’ I managed to say. This time I knew I was ready to take her advice and see psychiatrist Dr Stephen Pereira. After that acknowledgement I drove to the Lake District for those days of escape. And it felt like a release.

Since then I’ve been seeing Dr Pereira every week. He sent me to be tested for ADD, and it was the only test I ever passed first time!

Once I started to understand the condition, everything about me began to fall into place and make sense. As well as unravelling the tangled muddle of my life, I still have sessions of cognitive behavioural therapy (CBT) to help me change the patterns of my thoughts and behaviour.

Meanwhile, I’d given my GP permission to talk to my family, who had been desperately worried about me for months. At that stage I couldn’t talk to them and wanted an independent and objective professional to explain what was wrong with me.

You may wonder why I didn’t confide in them, but those who are closest to you are the hardest to speak to. It was impossible to let my loved ones know about the torture in my mind. Equally, anything they’d have said would have been rebuffed.

That’s why I withdrew from them, repelled their well-intentioned advice and finally stopped answering their calls and texts.

At the beginning of January last year, I took time off work. It was a huge relief, not having to dissemble any more, and to be fully employed in working on getting well.

I learned about depression and enjoyed going to therapy.

Bit by bit, shafts of sunlight started to penetrate the gloom. My family were proactive in helping me enormously — it has been an education for all of us to understand the complex nature of depression.

I also started to embrace my ADD, to understand that my impulsiveness, energy and capacity to be distracted were allied to a creative and individual mind.

I now view myself as a fire-starter. I have sparks of inspiration, but I need my ideas to be stoked by people who are better at the day-to-day running of a business.

I recognise, too, the role my dogs — Ella, Inca, Luna, Zulu and Mabel — have played in my recovery. Ella, particularly, has been my constant companion for ten years and she’s been with me to all my therapy sessions. In her own particular way, she has kept me going.

As a result, Ella and I now volunteer with the Pets As Therapy charity and Ella is a fully-fledged therapy dog for PAT.

People have asked me, too, if my public profile has made it harder for me. Would I have become so depressed if I hadn’t been subject to the pressure of public scrutiny that comes with my association with the Royal Family?

The answer is, I believe I would. But I wouldn’t have found a voice or an outlet for my story if it hadn’t been for the people I’m related to.

And that puts me in a unique position of privilege and trust. I feel I have a duty to speak out, so I can help others who are suffering as I did.

I know now that in doing so I am not admitting to a weakness. The stigma attached to mental illness is lessening.

Today — hard as it is to admit this — I am pleased I went through debilitating depression because I now have the skills to fight it.

I have a greater knowledge of my strengths and weaknesses and am a more confident person than I was before. The end result of this journey has been a positive one.

If I could leave you with just one thought, it would be this: ‘It’s OK not to be OK.’

That is the mantra that gave me the strength to speak out. Having done so here, it feels as if a great weight has been lifted.

No fee has been paid for this article. At James’s request a donation has been made to Pets As Therapy and Heads Together.

#james middleton #middsedit