The release of dozens of Hamas hostages is a time of celebration for families. Still, experts say the survivors may have a long mental health journey ahead.
"These are all people who do not know the extent of Oct. 7 — the conflict, the more than 1,000 people that were killed, the relatives that were missing and killed that they don't have homes to go back to," explained Israel Defense Forces spokesperson Major Doron Spielman.
While thanking the public for their concern, the family of 4-year-old American former hostage Abigail Mor Edan, whose parents were killed during that Oct. 7 attack, is asking for privacy.
"It's very important to let her be now with the family and no press and photographs and paparazzi," said Mor Edan's aunt, Ella Mor.
Privacy is a good thing, according to mental health care professionals. Trauma expert and Syracuse University professor Tracey Musarra Marchese says hostage survivors may experience things like anger, irritability, flashbacks and sleeplessness, which can be acute or chronic.
"Some people don't have the symptoms immediately. Other times it's somewhere down the road. They're just, you know, are getting back into real life, normal life and all of a sudden something could trigger a reaction in them," said Musarra Marchese.
Israel and Hamas extending truce another 2 days
The cease-fire has brought batches of hostages held in Gaza back home to Israel in exchange for release of Palestinian prisoners.
She adds the severity of mental health issues may also have to do with whether a patient has a history of trauma or mental illness.
Then there's survivor's guilt, which can come in many forms.
"It could be the family who's at home in the United States while their family member was held hostage overseas. This could be the soldier who was in the fire fight with their friend, and their friend died," said Musarra Marchese.
"Then there's another kind of guilt: That's guilt of omission or commission. What I should've done. 'I should've run away. I should've gotten my sister out of danger. We shouldn't have been there,'" said Dr. Walter Busuttil, director of research and training at Combat Stress.
Busuttil, a psychiatrist who worked with British hostages released from Beirut in 1991, tells Scripps News the good news is that many hostage survivors don't develop PTSD.
"Actually, it's the minority that have mental health problems. Many take stock of their life. When the chips are down and you think you're going to die, you make promises to yourself. We call this post-traumatic growth. Many actually become more spiritual. They appreciate life more when they are released, they take life easier," Busuttil explained.
For those who do need help, mental health experts suggest well-being checks, time with loved ones and space.
"In the first couple of days it's about reorientation, a private reunion with the family, a drip feed of news, but not all the news — especially if it's very bad — and physical checks," said Busuttil.
Israel Defense Forces officials say providing that support is top priority and a process they hope to repeat in the coming days.
"I think this is a challenge that few countries have had to deal with on this type of scale. And that's what we're trying to prepare for," said Spielman.
