Saeed Abedini's mental and emotional health has suffered after a long period of brutality in Iranian prison, according to a US congressman who has long campaigned for his release.
Robert Pittinger, an evangelical Christian who began working for Abedini's freedom in September 2013, said the pastor was physically well but his emtional health was more complex.
"It was a long journey to get him from an Iranian prison to freedom," Pittenger told McClatchyDC. "But as is the case with all former hostages, it's a longer journey back to an old life. Here, he's taking the first step of another long journey. It's a very challenging recovery."
"His kids want their daddy back," Pittenger said. "But their daddy is a different man than he was when he went inside that prison."
Iran, where Abedini was inprisoned from 2012 until last week, is a Shia Muslim theocracy with Ayatollah Ali Khamenei as supreme leader.
Although those considered to be 'ethnic Christians', such as Armenians or Assyrians, are allowed to practice their faith in Iran, the government is especially intolerant of those who convert to Christianity from Islam and converts are forbidden from praying in public churches. This is thought to be one reason why Abedini, a former Muslim, was dealt with harshly.
Abedini's wife, Naghmeh, created a Facebook page campaigning for his release which now has over 75,000 followers.
In 2015 the campaign was complicated after she revealed in an email to supporters that their marriage had been troubled and she had been subject to "physical, emotional, psychological and sexual abuse," through his addiction to pornography.
Saeed was released with the other three Americans as part of a prisoner exchange and flown to Germany over the weekend.