Yet another reality TV participant has met a tragic end.
Joe Cerniglia, the chef at New Jersey restaurant Campania, jumped to his death from the George Washington Bridge between New York and New Jersey on Friday, according to New York authorities. Authorities told reporters that the cause of Cerniglia's death is under investigation, but "no criminality" is suspected.
In 2007, Cerniglia was featured on celebrity chef Gordon Ramsay's restaurant rehab show, "Kitchen Nightmares."
On "Kitchen Nightmares," the often outspoken Ramsay unleashed on Cerniglia, a 39-year-old husband and father of three. Cerniglia was more than $80,000 in debt at the time his restaurant was featured on the show.
"Your business is about to f***ing swim down the Hudson," Ramsay said. "Why did you become a chef-owner if you haven't a clue how to run a business?"
In a cruel bit of irony, Cerniglia's body was found floating in the Hudson river.
It's not the first time someone from a Ramsay show has committed suicide: in 2007, Rachel Brown fatally shot herself a year after competing on Ramsay's "Hell's Kitchen," a series that sets up battles between up-and-coming chefs.
It should be noted that with both Brown and Cerniglia, their suicides came long after they appeared on their respective Ramsay shows.
For some reality TV participants, the drama hits only after their series goes on the air.
"Your life is an open book to people and that makes you feel very vulnerable," Nadine Kaslow, the chief psychologist at Emory University School of Medicine in Atlanta told ABCNews.com. "When people feel very publicly shamed and humiliated that's a risk factor for suicide. Part of what you don't know is how sensitive people are going to be to the shame and humiliation they might experience."
People with mental illnesses are obviously vulnerable. In the case of bipolar contestants, the reason they are attracted to these shows may stem from their mental illness and their desire to perform or be famous, Kaslow said. Mentally stable contestants are also vulnerable, especially when the pressures of competition and the public eye prove too great.
"They have no control or they lose control. They lose the boundaries that we all hold," Kaslow said. "People – the media and the public – aren't always so nice about them either. You can also go from being a star and really famous to being either a nobody or a villain."
That's why screening the participants before they join the show may not be enough.
"You have to be sensitive to them afterwards after they are out or lose. Now, the losers are on morning TV the next day. Most of us when we've had a public failure is not when we want to be on morning TV," she said.
"Obviously people are drawn to these reality shows," Kaslow added. "So we're not going to not have them. But people need to do a better job of managing and assessing the people on them."
Below, ABCNews.com looks at what happens when the realities of real life meet the realities of a television show and the devastating consequences for some show participants and their families: