In the world of online gaming, Desmond Amofah, 29, a streamer from Brooklyn, New York, who went by the name Etika, was prolific.

His boisterous personality helped him cultivate thousands of followers on YouTube and Twitch by playing and reviewing Nintendo games, specifically the crossover fighting game Super Smash Brothers.

“He was a great guy,” Rod Breslau, an esports consultant and journalist, said. “He was as large a personality in real life as he was online.”

But offline, it appeared Etika was struggling with his mental health. In the last few months, his online activity became more erratic and manic, according to Breslau.

Daniel Desmond Amofah, also known as Etika, in Culver City on June 9, 2018. @TheAlicePika / via Getty Images

On Tuesday, police confirmed Etika’s body had been recovered from the East River in Lower Manhattan less than a week after he went missing. His death has been ruled a suicide.

NBC News was unable to contact members of Etika's family for this story.

Etika had posted about suicidal thoughts to his Twitter, Reddit and YouTube accounts in the past, and when he did, worried followers called the police or had friends check on the gamer, Breslau said.

Experts say there have yet to be studies on the toll large followings can take on influencers or content creators, especially for those who already might be suffering from mental health issues, and they say more research into the topic is needed to understand the toll social media fame can take on a person.

“We’re only breaking the ice on how social media is affecting teens and adults but those are not influencers we’re studying, so I think these effects could be quite different,” Kaylee Kruzan, a researcher at Cornell University’s Social Media Lab, said.

In October of 2018, Etika’s YouTube channel, EWNetwork, was shut down after porn was posted to his page. YouTube declined to specify how many followers Etika had at the time his channel was removed, but Etika's friend and fellow YouTuber Daniel “Keemstar” Keem tweeted that the channel had more than 800,000 subscribers.

“He was a great Entertainer. One of the best streamers in the game. He lost a channel of over 800k subs and made a new one and was right back pulling thousands of viewers. Wherever he’s laid to rest I’ll be there. #JOYCONBOYZFOREVER,” Keemstar wrote, hashtagging one of Etika’s well-known and often memed phrases.

In April, he live-streamed a standoff he had with police officers, who later entered his apartment to check on him after he began posting cryptic tweets about harming himself, including a photo of himself holding a gun, according to Kotaku. “He was threatening suicide inside the apartment," police said. He was later hospitalized.

On June 19, Etika went missing after posting an 8-minute video titled “I’m Sorry” to a YouTube channel called TR1Iceman, in which he appeared to apologize to his fans and discuss suicidal thoughts.

“It does feel like things that happened online were directly responsible for the deterioration of his mental health. Being a huge personality online and having a ton of fans in the gaming community can be very, very stressful … and Etika is one of most experienced people in dealing with communities online,” Breslau said.

Etika’s talk of suicide was rarely shrugged off, but because he was known to troll his fan base, the thought that he could be acting out as part of a gag flickered through the minds of those who followed him, Breslau said.

“Everything was taken seriously, but some of it seemed like an Andy Kaufman-like troll,” Breslau said. “No one knew what was going through his mind.”

Dr. Victor Schwartz, chief medical officer of The Jed Foundation, said that only those who were close with Etika would be able to decipher his increasingly bizarre behavior as a troll or a cry for help.

“This … bizarre content would suggest somebody who has maybe developed a strange sense of humor or it maybe someone having psychotic episode, and if you don’t know that person you’d have no way to define that,” Schwartz said.

Schwartz said younger people are currently the most affected by suicide in the United States.

The Centers for Disease Control and Prevention lists suicide as the No. 10 leading causes of death in the U.S. overall, but lists it as the second leading cause of death for teens and young adults.

Among younger Americans, Schwartz said, research shows more time on social media can lead to feelings of anxiety, depression, suicidal thoughts and impulses — but those studies look at average users, not influencers. He added that one silver lining is that sometimes people who use social media a lot are more willing to share their depressive thoughts online, which can get them the help they need.

"Something that’s unfortunate is that we don’t have a ton of data to say what happens when someone is extremely online or very public," Kruzan said.

Kruzan said she thinks social media platforms are taking steps in the right direction to intervene when someone threatens self-harm on a site, but added that everyone — from users to clinicians — has a role to play in preventing suicide.

"We’ve seen changes in the last couple years with media giants taking on efforts to identify and intervene in cases of self-harm and suicide, and I feel there are sites that are taking a real active role bringing in researchers and clinicians to inform their algorithms," Kruzan said. "I feel hopeful on that, but it is a key area of work."

Schwartz said that Etika’s online community appeared to take the right steps to get him help when he posted about feeling suicidal, but added that sometimes mental health institutions fail to meet the needs or follow up with those who are struggling.

“We don’t hear about all the situations where someone has gotten into the system because it doesn’t become a story,” Schwartz said. “We don’t hear about the positive outcome of these interventions … It happens and it save lives but unfortunately we don’t succeed with everyone.”

Breslau said he hopes Etika’s death causes a greater discussion about suicide not just among gamers and content creators, but also among the general population.

“It really is a huge loss for everybody here. He was such a pillar of the Smash community, the Nintendo community,” Breslau said. “The YouTuber and the entire gaming community really loved what he did and loved the content he produced, and he will go down as one of greatest entertainers in video game history.”

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit www.speakingofsuicide.com/resources.