Most audiences are interested in what happens on television when the reality show cameras are rolling, but it's what happens after the filming has ended that can often be the most dramatic.
Some contestants have had breakdowns and even committed suicide after participating in reality TV shows. According to TheWrap.com, which did an investigation into reality show suicides, 11 contestants or would-be contestants from reality TV shows around the world have taken their lives.
"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 is not enough, Kaslow said.
"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."
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 reality show participants and their families:
The 30-year-old one-time "American Idol" contestant had an apparent infatuation with judge Paula Abdul. Goodspeed was ridiculed and flatly rejected by the judges during her audition, but never gave up her obsession with the former Los Angeles Lakers cheerleader and pop star.
On Nov. 12, 2008, Goodspeed parked her car a few doors down from Abdul's Los Angeles home and, according to Los Angeles police, died from an apparent overdose.
At the time, Reuters reported that prescription pills, along with CDs and pictures of Abdul, were found in the car.
Later, Abdul told ABC's "The View" that Goodspeed had been stalking her for 17 years and later told co-host Barbara Walters on Walters' radio show that she pleaded with Cowell and the producers not to let Goodspeed audition.
They did, she said, for the "entertainment value. It's fun for them to cause me stress. This was something that would make good television."
In an earlier interview on "Good Morning America," she said, "what people don't realize, this was a serious, serious situation."