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Skates grew up near Mold, Flintshire, and was the first member of his family to go to university.
He said his childhood was shaped by the industrial decline that followed large-scale job losses at Shotton steelworks, where both of his parents worked, and that left him with a strong sense of injustice, helping draw him into politics.
His mental health struggles "really manifested in an obvious way" at Cambridge and he struggled to get through university.
"Where I went was unfamiliar to me, it was like nowhere I'd ever been before, and there were practices and behaviours that were completely alien to me," he added.
"I'd never worn a jacket before, or a blazer, let alone a gown.
"To do that in the first few days, while having wine tasting, set me off I think, and made me question: 'Why am I here? What am I doing here? This is not me. I'm really worried about this place.'
"It got worse and worse, this feeling that I didn't really belong here."
Skates began experiencing dissociation, a symptom associated with anxiety and depression and described it as feeling detached from himself and reality.
"It feels like you're dreaming your day away," he said.
After initially struggling to get help, he was diagnosed and prescribed antidepressants, but he had experienced anxiety long before then.
"Actually growing up, I was incredibly anxious. Really anxious," he said.
"I was always keen to please. And I think it was about just this need to avoid conflict."
Asked whether those feelings remained with him today, Skates replied: "Yeah, definitely. But I'm very mindful of it."
He said talking therapies had helped him understand his condition and develop ways of managing it.
"That was just like a game changer."
If you've been affected by any of the issues raised in this story, help and support is available via BBC Action Line
