A Massachusetts man who disappeared from his South Carolina vacation rental and was found dead 10 days later died by suicide, officials said.

Beaufort County Coroner David Ott said Tuesday that Stanley Kotowski, 60, died by asphyxiation from hanging himself, the Island Packet reported.

Kotowski’s body was found Monday beneath another home four houses down from his family’s rental on Hilton Head Island. Ott said he likely killed himself the day he went missing, August 16, and that there was an “apparatus” involved.

“It’s definitely asphyxiation, but there’s no other word other than hanging,” Ott said. “Unfortunately, people believe that hanging means you rope up to a ceiling and you drop. It’s definitely not like that … It’s mainly cutting off the flow (of oxygen).”

Kotowski left the rental at Sea Pines Resort, barefoot and not carrying any personal items, as CrimeOnline reported. His wife, Jackie Kotowski, said her husband had become paranoid in the weeks leading up to the vacation.

“He just walked out the door,” she said. “He had really bad insomnia for about a month. He doesn’t have dementia. His anxiety just kept getting worse and worse and worse and he started to get a little paranoid.”

Jackie Kotowski told investigators that her husband “believes Sea Pines is a ‘set up’ and has a conspiracy that the people here are out to get him. She stated that Stanley has made several statements of people at this place ‘watching him.’”

Before leaving the house, she said, he asked her to  “promise me you will go on without me.”

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[Featured image: Stanley Kotowski/family handout]