What I saw over there was a large portion of his community pleading with him to delegate administrative tasks to the community, as it became increasingly clear the website was becoming too much for a single guy to manage (he was the only moderator of like 30+ communities that were full to bursting with spam, as well as the sole site admin). He never approved the many applications to help moderate, and said he was extremely slow to trust others, so never appointed a second admin, and instead just continued to silently work on the codebase as the site became unusable from spam.

I think his extreme distrust and desire to do everything himself combined with his medical issues led to extreme burnout, and ultimately its downfall.