You strengthen some muscles. You tighten up some of the flabby paunch. And after your blood's raced through your body like it's a NASCAR course, you leave sucking on a water jug spiked with a shot of accomplisment, a splash of optimism.
Now imagine if you suffered from depression, anxiety or another chronic mental illness. Wouldn't a trip to the gym render a similar beneficial jolt?
That's what a couple hundred mentally ill people in Manchester are experiencing, thanks to a statewide, experimental program that is getting them out of lonely apartments and into gyms. There they are pumping iron, running treadmills and getting tips on proper eating.
"It's changed my whole life, my whole outlook on things," said Mary Keeler, who is 68. Twenty-one months ago, she was 230 pounds and gaining. She took 13 medications, had no energy, and stayed home.
Now she carries 176 pounds on her 5-foot, 7-inch frame, and her arm muscles slightly ripple as she curls a barbell at the Manchester YMCA.
Keeler has eliminated medications for cholesterol, blood pressure and sleeping pills, and significantly lowered some of the psychiatric medications she takes for depression, she said. "I feel liberated," she said.
The liberation comes from In Shape, a program that The Mental Health Center of Greater Manchester (more commonly known as Manchester Mental Health) provides to about 200 of its clients. It's part of a statewide, $10 million research project funded by the Center for Medicaid Services. If successful, In Shape could become an evidence-based service eligible for Medicaid payments countrywide, Snow said.
Participants get a twice-weekly trainer to guide them through an exercise routine and a 1-year free membership at a local gym.
The need for In Shape is obvious, given some of the health problems that many mentally ill people cope with. Research has shown the life span from some mentally ill people is 30 years shorter than the general population, Snow said.
Some of that is due to preventable behaviors — smoking, diet, overeating. Other health problems come from the side effects of psychiatric medications, which include weight gain, loss of appetite and lethargy. Finally, there is the social isolation, stigma and poverty associated with mental illness.
Of course, they reinforce one another. The newspaper runs an article about a violent attack by a schizophrenic. The stigma forces someone inside, where he smokes and overeats. Then he gets depressed, so he takes more medication. The side effects worsen, so he stays inside. Lather, rinse, repeat.
But could something as simple as physical activity break such a cycle?
Snow cautioned that a workout regiment won't cure mental illness, but it could help reduce symptoms enough so a patient can live comfortably, he said.
Like Jessica Gaertner. She was 260 pounds before she enrolled 21 months ago. She ate, she said, because it felt good — frozen dinners, cookies, chips, ice cream. She felt stuck in her room at a group home, where she watched TV, stayed on the computer and slept.
Now she's 155 pounds. The 26-year-old attends the gym two or three times a week, and it's nothing for her to walk a couple of miles to the Mall of New Hampshire or Fresh Market in Bedford.
Her trainer, John Curtis, said Gaertner has avoided hospital stays because of the activity. "I didn't like the way I was. It was depressing, I was big," Gaertner said. "I'm happier now."