So you’ve been freed by North Korea. What happens now?

One went back to work as a street repairman in a small Ohio town. One became an author. Two returned to journalism. Two others are now dead. They all have one thing in common: They’re Americans who were once held prisoner in North Korea.

When Secretary of State Mike Pompeo returned from his latest trip to Pyongyang on Wednesday, he brought back three more members of this unfortunate club. The freed men arrived at Joint Base Andrews in Maryland early Thursday, where they received a hero’s welcome from President Trump and Vice President Pence.

“We want to thank Kim Jong Un, who was really excellent,” Trump said. “This is a special night for these three really great people, and congratulations on being in this country.”

Two of the men raised their arms triumphantly as they exited the plane, and they appeared to be in good health. But now that they're home, they face another hurdle: readjusting to life after being held prisoner by one of the world’s most repressive regimes. According to a former prisoners and a U.S. diplomat who helped free North Korean hostages, the process may not be easy.

“After they get home, after the fanfare is over, they’re usually traumatized,” former U.N. ambassador Bill Richardson told VICE News. “They’re troubled. They go through periods of depression. This is the general pattern.”

Richardson went to Pyongyang in November 1996 to bring home Evan Hunziker, who swam across the Yalu River from China into North Korea in August of that year. North Koreans accused the 26-year-old Hunziker of being a spy, but he claimed that he was a missionary who wanted to preach the gospel. Hunziker struggled with drug and alcohol problems and died by suicide within a month of his return to the States.

“I could tell he was upset; he didn’t say a word,” Richardson said, recalling the plane ride home. “I remember just deciding not to try to engage. I said, ‘Evan, we’re taking you home, pal. You’re going to get a little checkup.’ He smiled and waved, then we got him out.”

Following their moment with Trump, the freed prisoners were scheduled to visit Walter Reed National Military Medical Center for a medical exam. Freed prisoners also undergo interviews with U.S. consular officials, but otherwise there’s not much in the way of debriefing.

One of the newly freed men, Kim Dong-chul, said through an interpreter that his first moments of freedom felt “like a dream,” but he also suggested his experience in North Korea was difficult.

“We were treated in many different ways,” he said. “Me, I had to do a lot of labor, but when I got sick, I was also treated by them.”

Read: Who are the three US prisoners released by North Korea?

American hostages have reported wildly different conditions during their imprisonment. Kenneth Bae, a Korean-American Christian missionary, was arrested in November 2012 and accused of proselytizing in a country where religion is banned. He spent more than 700 gruelling days performing hard labor on meager rations. Meanwhile, Matthew Todd Miller, a white American who traveled to North Korea in 2014 with a plan to get arrested and renounce his U.S. citizenship, recounted a relatively cushy stay in a guest house, where he passed the time playing billiards with his English translator.

Both Bae and Miller were freed at the same time in November 2014 by former U.S spy chief James Clapper. Bae wrote a book about his ordeal and has publicly advocated for Korean unification, while Miller seems to have withdrawn from public life.

Several Americans have returned to relatively normal lives in the aftermath of their North Korean imprisonment. Jeffrey Fowle was arrested in May 2014 and spent 140 days locked up for intentionally leaving a Bible in a public place. He said he spent his time in detention making lists of Beatles songs and doing sudoku puzzles. Upon being freed, he returned to his native Ohio and got his old job back, repairing streets for the city of Moraine.

In a phone interview with VICE News, Fowle said he had “a pretty smooth transition,” even though he received no special counseling or assistance. “There’s no long term issues,” he said. “I don’t have any flashbacks or anything like that.”

After the media lost interest, Fowle said he was basically left alone. The government wasn’t even particularly interested in hearing about his experience, which he found surprising.

“I didn’t have any kind of debriefing until about two months later,” Fowle said. “A couple guys came to my house and we ended up talking for four or five hours, but they weren’t pressing me on any intelligence information. They were just asking what the situation was like for me over there. They didn’t seem to be surprised with anything I told them.”

Two other former North Korean prisoners, journalists Euna Lee and Laura Ling, have also since returned to their professions. Both were arrested in March 2009 while filming along North Korea’s border with China, and they were imprisoned for 140 days before Bill Clinton helped secure their release. Lee has described moments of kindness by guards, and said she was asked “if one-night stands really happen in the US.” But overall, her experience in North Korean jail was not pleasant.

“Every day was like a psychological battle,” Lee said in a TED Talk. The interrogator had me sit at a table six days a week and had me writing down about my journey, my work, over and over until I wrote down the confession that they wanted to hear.“

Another former prisoner, Christian missionary Robert Park, spent 43 days in custody after he illegally crossed the border with China, smashed a photo of former North Korean leader Kim Jong Il, and shouted “South Korea and America love you.” Park has said he was tortured and sexually abused by his captors, and called the treatment he received “humiliating” and “worse than death.” The Washington Post reported in 2014 that he had spent time in a psychiatric hospital in Tucson before moving to Seoul to work as a human rights activist.

Most recently, Otto Warmbier, a college student at the University of Virginia, was held captive for more than 500 days after he was accused of attempting to steal a propaganda banner from his hotel during a tourist trip to Pyongyang. He was in a coma when he was released last June and died six days after being sent home.

On April 26, Warmbier’s parents filed a lawsuit against North Korea in federal court, alleging that he was “brutally tortured and murdered” by the “criminal” Kim regime. They are seeking monetary damages, which could come from a fund created by Congress in 2015 to compensate victims of state-sponsored terrorism.

A spokesperson for the Warmbier family declined to comment Wednesday, but released a statement that said, “We are happy for the hostages and their families. We miss Otto.”

Two of the three recently freed prisoners — Kim Hak-song and Tony Kim — were affiliated with the Pyongyang University of Science and Technology, a private school founded by a Korean-American evangelical Christian. The former was arrested for “hostile acts” toward the state and the latter was accused of trying to overthrow the government. Both men were jailed in the spring of 2017. The third freed detainee, Kim Dong-chul, is a businessman who was accused of spying and sentenced to 10 years of hard labor in April 2016.

It's unclear what the three men will do now. Richardson said they can expect intense media attention in the coming weeks, but that it will eventually fade away. And that’s when life after North Korea gets challenging.

“That’s when I think the reality sets in,” Richardson said. “The trauma sets in and a little sadness.”

Cover image: Early Thursday morning President Donald Trump greets freed American detainees from North Korea on the tarmac of Andrews Air Base May 10, 2018. (Photo By Sarah Silbiger/CQ Roll Call)