Honestly? I genuinely think it's a bit of both those things. I'm not denying a lot of creators, especially NTR ones (NTRMAN, TerasuMC...), have mental issues or suicidal tendencies, it's just that, and excuse me for being vulgar here, when there's money involved (game development, patron-based subscriptions and so on), I often fail to take any of these kind of posts seriously.
But hey, taking the human aspect out of this I still think After looks and sounds incredibly good, I hope shinachiku can find it in himself to bring it to a completion safely, we're all rooting for him.