The complications of family can be tough enough as is. Add mental illness, specifically paranoid schizophrenia, and tear two twins apart with it, and you’ve got the makings of an emotionally harrowing drama. Perhaps it’s no surprise then, this new limited series, “I Know This Much Is True”—about one brother trying to save and be there for his twin, as his own life collapses— comes from acclaimed writer and director Derek Cianfrance. Known for “Blue Valentine,” and “The Place Beyond the Pines,” Cianfrance knows a thing or two about the destructive qualities of love, family and the empathy behind trying to keep it all together.

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Debuting this April, his six-part limited drama series stars Mark Ruffalo (Emmy winner for HBO’s “The Normal Heart”), who also serves as an executive producer, as identical twin brothers Dominick and Thomas Birdsey in a family saga that follows their parallel lives in an epic story of betrayal, sacrifice and forgiveness. The series shows Dominick and Thomas at different stages in their lives, beginning in their present with both brothers approaching middle-age, filled in with Dominick’s flashbacks to their young adulthood. 

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The cast, as you might expect, is jammed with terrific talent too. Melissa Leo (Academy Award winner for “The Fighter,”) stars as the twins’ mother, Imogen Poots plays Dominick’s live-in girlfriend, Rosie O’Donnell plays a social worker, Archie Panjabi plays a newly appointed psychologist; and the cast is rounded out by Kathryn Hahn, Juliette Lewis, Bruce Greenwood, Rob Huebel Aisling Franciosi, John Procaccino, Philip Ettinger, Michael Greyeyes and many more.

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Centered on the difficult idea of not giving up on the ones you love, “I Know This Much Is True” debuts on April 27. The limited series will also be available on HBO NOW, HBO GO, HBO On Demand and partners’ streaming platforms. Watch the newest trailer below and don’t be surprised when Ruffalo receives another Emmy nomination.