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."
Cowell defended himself and the show's producers in an interview in US magazine last December. "What happened was awful," he said. "My regret in all of this was that we didn't know how troubled this person was. If I could've gone back in time and known what she was going through, I wish that we could've spent time trying to help her, but we genuinely didn't know."
The former deputy district attorney from Reno killed herself after she was bounced from "Pirate Master," the CBS reality show that followed 16 would-be modern-day pirates on their quest for $1 million.
The fourth person to leave the show, Kosewicz, 35, was found dead in her home on Jan. 27, 2007, from an apparent suicide. Before committing suicide, she reportedly wrote on the MySpace page of a fellow contestant that she had "lost the strong Cheryl and I'm just floating around lost."
She also blamed the show for coming between her and her boyfriend Ryan O'Neil, who committed suicide himself two months earlier. "This frik'n show…was such a contention between Ryan and I," she reportedly wrote at the time. "The shame seemed to get to her," Kaslow said. "The note was so public and was, in part, blaming the TV show."
Kaslow added that there are often several factors that lead to a suicide and, in Kosewicz's case, losing her boyfriend could have been an additional stressor, while being eliminated from the show may have been the final straw. In the show's final episode, there was a dedication message to Kosewicz.
CBS did not respond to repeated requests for comment.
The "Partridge Family" star allowed VH-1 cameras to follow every detail of=2 0his life for "Breaking Bonaduce," including even an apparent suicide attempt.
According to entertainment web site TheWrap.com, the former child actor tried to kill himself by swilling Vodka and Vicodin after his wife Gretchen asked for a divorce during the filming of the reality show – and just prior to the Sept. 12, 2005 premiere. In another episode, he slashed his wrists before checking into rehab.
His behavior only made the show more popular. It was brought back for another season and picked up for international distribution. In the end, his marriage to Gretchen fell apart. But Bonaduce has continued to seek the limelight as a radio personality.
VH-1 did not respond to repeated requests for comment.
The 23-year-old boxer from Philadelphia was reportedly the first reality television show participant to take his own life.
A contestant on the first season of NBC's "The Contender," Turpin shot himself in a parked car just weeks before the series premiere.
According to the police report, Turpin had been sitting with his girlfriend, with whom he had been having a custody dispute over their 2-year-old daughter. According to media reports he was also said to have grown frustrated, after being knocked out of the show early, that he was not allowed to compete in any professional boxing matches until the series' finale aired, which would have made it hard for him to support his family.
His former trainer Percy "Buster" Custus also told ABCNews.com that Turpin was never mentally fit to be on the show. "He wasn't even supposed to be on the show," said Custus, a former Golden Gloves boxer. According to Custus, Turpin not only failed a psychological evaluation for the show but had previously attempted suicide. Nonetheless, Custus said, the young athlete was pushed to join the show.
The network established a fund for Turpin's family, but Custus believes NBC could have done more. "I'm not happy with how they treated Najai," he said. "I'm not happy with the fund either."
NBC did not respond to requests for comment.
James Scott Terrill
The Georgetown, Ky., single dad appeared on the ABC reality show "Supernanny" in January 2008, seeking help in managing his two sons, Lane, 11, and Tate, 5, after their mom abandoned them.
But after the cameras left, Terrill was reportedly still struggling with parenting solo. On July 4, 2008, he called Georgetown police from the cemetery where his father was buried and threatened to shoot himself in the chest. Police stayed on the phone with him for nearly an hour but in the end the 37-year-old took his own life.
ABC Entertainment, declined to comment. ABC Entertainment is part of The Walt Disney Company, the parent company of ABC News.
In the second installment of "Paradise Hotel," the Fox reality show in which participants compete to see who can stay in a luxury hotel the longest, 25-year-old Clutter appeared, even though he had committed suicide just after production was wrapped on the show.
Originally the show covered his Oct. 12, 2007 death by saying the former call center employee had fallen during a climbing accident. But after an investigation by the Sheriff's office outside Amarillo, Texas, where he died, it was determined that Clutter had actually jumped from the top of a cellular tower.
"There were no findings of foul play [and] all evidence and findings show that [Clutter's death] was a product of his own demise," read the Sheriff's report obtained by RealityTVWorld.com.
A member of the Sheriff's Office was also quoted saying that Clutter battled depression and bipolar disorder and his family had recently wired him money so he could return home and receive treatment.
His family and producers agreed to keep in Clutter's scenes, according to Broadcasting & Cable.com.
Fox did not respond to requests for comment.
Reality shows in other countries have experienced similar tragedies, proving it's not just an American phenomenon. In fact, the 1997 suicide of a Swedish man who participated in the forerunner to the "Survivor," series, a show called "Expedition: Robinson," produced by Mark Burnett, led Burnett and other producers to screen potential contestants through psychological testing before they were casted. Nevertheless, several incidents have occurred since then.
In England, two contestants killed themselves and another reportedly tried after participating in reality shows, according to TheWrap.com. Simon Foster was found dead on April 15, 2008 presumably from an excess of methadone and alcohol, after he did English version of the show "Wife Swap" with his then wife Jane. Carina Stephenson, a 17-year-old English girl, took her life in May 2005, two weeks before her role on the UK reality show "The Colony" was to air.
Jo O'Meara, who appeared on England's "Celebrity Big Brother," downed pills and whiskey after she was accused of being a racist and a bully on the show and received death threats when it was over. She survived after a friend found her, but O'Meara was still furious with producers for "abandoning" her, she told Britain's News of the World in March 2007.
"I actually did hardly anything on that show, but it made me look like some monster," she said. "Then when the show finished playing with me like a puppet it abandoned me and left me to sort out my problems, knowing just how bad I'd become."