While Thursday's release of American prisoners from Russia was marked by celebration and relief, the former captives could face future health challenges, experts say.
Wall Street Journal reporter Evan Gershkovich and American veteran Paul Whelan were among those released from Russia on Thursday in a large prisoner swap.
A third U.S. citizen, Russian-American journalist Alsu Kurmasheva, was also released.
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A plane carrying the freed Americans landed at Joint Base Andrews in Maryland late Thursday night, where they were greeted by President Joe Biden and Vice President Kamala Harris.
The newly released prisoners were then flown to San Antonio, Texas, for evaluation and rehabilitation at Brooke Army Medical Center, a premier military medical facility, according to reports.
Although the prisoners are safely back on U.S. soil and have been reunited with their families, they may experience mental health challenges stemming from the trauma of detainment, said experts.
"Besides the obvious threats to one’s safety and the horrifying prospect of confinement, a situation like this is fraught with uncertainty," Dr. Norman Blumenthal, director of the Ohel Zachter Family National Trauma Center in New York, told Fox News Digital.
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"Ambiguity in and of itself induces stress — and that, coupled with their very predicament, can create a marked escalation of trauma." (None of the experts cited here have treated the released Americans.)
Dr. Karen DeCocker, a psychiatric mental health nurse practitioner director at Stella Centers in Chicago, noted that being held captive can lead to several types of trauma.
"This varies from person to person based on prior history and the experiences encountered during captivity," she told Fox News Digital.
While each person reacts differently to trauma, Blumenthal predicted that the freed prisoners would likely experience an "initial thrill and exhilaration" from their liberation.
"The celebrations and enthusiastic reunions with loved ones can temporarily overshadow the trauma," he noted.
"As life returns to normal and routines set in, that is often when the frightening flashbacks and intrusive recollections can become disruptive and destabilizing."
Dr. Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at NYU Langone Medical Center, said it is likely the prisoners experienced physical and mental abuse, sleep deprivation, dehydration, malnutrition and possibly infections.
Jonathan Alpert, a psychotherapist and author based in New York City, said that Gershkovich, Whelan and Kurmasheva, along with the other released prisoners, may suffer from both acute stress disorder (ASD) and post-traumatic stress disorder (PTSD).
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ASD is a short-term mental health condition that typically occurs within a month after a traumatic experience, according to Cleveland Clinic’s website.
"Acute stress disorder may include flashbacks, nightmares, intense fear and high anxiety," Alpert told Fox News Digital.
It can also include feelings of numbness or detachment.
PTSD occurs when such symptoms persist for a month or longer, and the anxiety becomes chronic, according to Alpert.
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PTSD may include many of the same symptoms as ASD, and can impair the person’s ability to function in daily activities.
The freed prisoners may also experience depression, anger and difficulty trusting others, said Alpert.
"I've also seen people have trouble focusing and making decisions in light of a trauma," he added.
It could also be challenging for the former prisoners to reintegrate into their normal environments and social groups, Alpert said.
Symptoms of trauma are "not universal," Siegel told Fox News Digital.
"There are differences, and not everyone experiences PTSD," he said.
"Common symptoms include flashbacks, nightmares, depersonalization and derealization, anxiety and depression."
DeCocker noted that symptoms can be both mental and physical — including the following five points.
"Individuals may experience dissociation, where they feel disconnected from their thoughts, feelings or sense of identity," DeCocker told Fox News Digital.
"This can manifest as feeling detached from oneself (depersonalization) or from the world around them (derealization)."
Some trauma survivors may feel a sense of guilt for having survived a traumatic experience when others did not, or for putting themselves or others in situations that led to captivity, DeCocker said.
They may also feel guilty about the stress and anxiety that family members and loved ones experienced during their imprisonment.
"Issues with trust, intimacy and personal relationships often occur with survivors and their families," DeCocker told Fox News Digital.
"The impact of their captivity often comes from their inability to relate the experience to others."
Trauma survivors may experience feelings of shame, worthlessness or confusion about their identity, according to DeCocker.
"In this case, where there was an exchange of prisoners, there may be added complexity," she said.
It's not uncommon for trauma survivors to have negative beliefs about themselves or the world, according to DeCocker.
"Generalizations about the world being unsafe or out of their control can occur," she said. "Threats are often seen in everyday experiences."
Given the high-profile release, Gershkovich and Whelan will likely receive a large amount of media attention, Alpert noted — "but it’s important that they have the space and privacy they need to process this on their own timeline."
DeCocker agreed, stressing the importance of taking extensive time to heal and recover.
"There is no rush to reintegrate," she told Fox News Digital. "Time is best devoted toward rest and restoring a sense of balance and normalcy."
Embracing daily routines and structure can help with that, DeCocker said.
The freed prisoners may also want to avoid spending too much time on social media and the news in the early days to avoid retriggering discussions and events, she advised.
One "tried-and-true method" of coping is to retell the events to supportive people who act as listeners, not solvers, according to Blumenthal.
"Putting the experience into words can help with healing and adjusting to the more mundane aspects of life and routine," he said.
If symptoms are interfering with day-to-day functioning, Alpert recommends seeking professional help.
"In the case of a severe trauma, such as being held prisoner and wrongly convicted, symptoms may not surface right away," he pointed out.
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"It can be helpful to get ahead of it and speak to a specialist."
All forms of professional help are useful, DeCocker noted. Those include talk therapy, psychiatric support, interventional treatment modalities specific to treating trauma, and physical treatments and therapies to heal the body.
Other treatments may include cognitive behavioral therapy, relaxation techniques, and medications such as beta blockers, antidepressants and potentially psychedelics, according to Siegel.
Support from loving family members and friends is also key, the doctor added.
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Most people do have an "inherent resilience and capacity to hope," Blumental said.
"These and other freed hostages may, on their own, mobilize and harness strength and heroic reformulations of their recent incarceration to go on and resume normal functioning."
Scott McDonald of Fox News Digital contributed reporting.
