To answer the last bit from a point of view of someone who delved into quite a lot of things, and tryed producing a wide range of things, you focus far more easily on that one negative comment, even more when you feel like there's real point being made.
Imagine doing something, and everyone praise you for it, and you think everything in it is fine, and one guy come and tells you there's something wrong, it doesn't have to be in a dick way, just pointing out something wrong when you though it was right can leads to you overthinking the negatives, and makes you feel like they're worse than they really are.
In short, like always the mind tends to focus on the negative rather than the positive.
That's also why I try to nuance my critics, telling the person the faults is as important as telling them how much you like what they do, I, personnaly, tend to get much more rational and stay calmer when the guy who point out the negative points, also tells me what's good and how he liked it overall, nuance when talking about a creation is probably the best way to both get your point accross if you feel like something is "bad", and to also support the guy who did it.
Well, all of that is mostly from personnal experiences, and from what I saw.
So I guess, like BD said, it's probably not the making of the game itself that takes a toll on him, but probably something as a whole, and when things aren't going your way IRL, you tend to focus much more in the negatives than anything else in your work. Of course that also doesn't help, the human mind is kind of a dick in these times.
All I can do is hope for the best for BD, and I think taking a month off payment seems to be the best course of action for him, it will allows him to take some deserved time off, and he can get ahead of his schedule. I just hope he wont feel the need to drop something big next month in guilt for him taking time off (I can attest how easy it is to feel guilty when you take more time than you announced, and how easy it is to fall into the trap of thinking you have to offer more to compensate)
All in all, I just wanted to come here since it's been quite a while, to give my support to BD, he's not as accustomed to making games as other big creators, getting so huge so quickly can lead to a lot of pressure, I just want him to take it easy.