How am I doing? Let me get back to you on that.

It happens to all of us. You run into an acquaintance in the drug store, or a friend you haven’t spoken to in a while calls you. You greet each other and then they ask the question that can really throw you for a loop…

“How are you doing?”

Such a simple question, yet I never know how to answer it. Should I be honest? How much information should I offer? Or maybe I should just say “I’m good” to avoid any awkwardness. Navigating this basic social interaction can be tricky, especially during those times when your chronic illness is really kicking your butt and things are definitely not good.

Why it’s so hard to answer

I say it’s a simple question, but for people with chronic illness, it’s really not when you think of all the things you need to consider as you formulate your answer:

How well do I know this person?
How much energy am I able to spend on this conversation?
Does this person genuinely want to know how things are going in my life?
How much am I willing to share?
How might this person respond to me?

For someone like me who struggles with brain fog on a daily basis, it can be daunting trying to process all these variables in a split second while the other person is waiting expectantly. I often start feeling very anxious and frustrated (at myself) in these situations, not only because of the mental exertion required, but I also worry that I’ll say the wrong thing, share too much, or come off sounding whiny.

Let’s break down each of those variables, so that hopefully you’ll feel more prepared the next time someone asks you how you’re doing.

How well do I know this person?

If the answer is “not at all” then it’s a no brainer: save your energy. While I can attest from my years working in retail that some people do take a cashier’s friendly greeting as an open invitation to share some very intimate details, there’s no need to share your whole life story with the person who’s bagging your groceries.

But let’s say you’re at least acquainted with this person. It feels dishonest to say that everything is awesome in your life, but you also don’t want to make them back away from you awkwardly after you’ve shared just a little bit too much. In that case, consider one of these approaches:

Tried and True: “I have good days and bad days.”
Optimistic:  “Still struggling with my health, but I’m making the most of things.”
Brutally Honest, But Vague:  “Not very good, unfortunately, but thank you for asking.”
Deflection:  “Well, I’ve been dealing with some health issues lately. But tell me how you are, do you have any recent pictures of your kids?”

These responses don’t offer all the ugly details of life with chronic illness, but they still let the other person know that things are not all rainbows and unicorns for you. They may even find your honesty refreshing in this age of presenting only your best and happiest self on social media.

Obviously, the better you know someone the more honest you can be. You might be surprised at how much better you feel after laugh-crying with your BFF about all the absurd ways your body has managed to dysfunction.

How many spoons do I have for this?

Let me emphasize here that I am always thankful to get a message from someone that lets me know they care. I’m very fortunate to have so many people who love me and just getting a quick hello from them means the world to me.

But sometimes I only have enough energy to read that message and appreciate the sentiment. Even if I did have a little bit more energy, my cognitive impairment makes it ten times harder than it should be to formulate the words for an appropriate response. It’s difficult and exhausting to explain that level of fatigue to people who haven’t seen me on a daily basis since I became sick. So I sometimes end up not responding to their message at all and to those people I want to say “I’m sorry, please don’t take it personally. I really appreciate you reaching out, I’m just not capable of coming up with an honest but appropriate answer right now.”

Does this person genuinely want the truth about how I’m doing?

I’m not implying that any of your friends, relatives or acquaintances simply don’t care about you. But do ask yourself – is this person willing, able and prepared to really listen to the sometimes-ugly truth?

Did they reach out to you and indicate a true desire to learn about your illness and how it affects your life? Or are they in a hurry and don’t have time to listen to the hour-long tale of your health insurance fiasco? And let’s be honest, sometimes you get the feeling that they’re just asking so they can check off the proverbial box: “Yes, I have checked on my sick friend recently. Done.”

I’ve also found that discussing an illness can make some people feel uncomfortable. In my experience, the younger the person the more this seems to be true. I mean, what healthy 30-year-old in the prime of their life wants to face the concept that a life-altering illness or injury that could just as easily happen to them at any moment? An honest conversation about your health struggles may be a scary reminder to them of their own vulnerability and it may be difficult for them to process.

I’ve found that navigating this issue just takes a lot of practice. Unfortunately, I have on quite a few occasions expended precious energy giving an overly detailed update of my health status, only to eventually catch on that what they really wanted to hear was a quick “I’m hanging in there!” Two years into my illness, I’m getting a little better at reading the signals the other person is giving me and you will too.

How much am I willing to share?

Okay, so you’ve established that a close friend genuinely wants to know how you’re doing and you happen to have some spoons to spare. Wonderful! Now you just need to decide if you want to tell them that your new medication is giving you “some side effects” or if you share the gory details of why you spent the entire weekend in the bathroom.

I personally feel that having your life turned upside down by chronic illness is bad enough without broadcasting a full rundown of all your bodily functions to the entire world. I tend to keep that type of information to myself, my parents, my bestie and maybe some other people who have the same illnesses I do just to compare notes.

However, I will gladly share some basic “insider” information about my illnesses with literally anyone who’s willing to listen in the name of awareness and advocacy. So I’m very willing to explain to people what my typical day looks like living with chronic illness and just how bad things can get at times, while keeping the specifics of my nasty drug side effects to myself.

How might this person respond?

It feels very validating to hear“Oh my, you have been going through a difficult time!” You’re not seeking attention or pity and you know that whatever they say probably won’t make the reality of your illness any better. But I think we all have a deep-seated need to have another human acknowledge our troubles and triumphs occasionally. We all need to experience compassion. I understand that more than ever now that I’m living with chronic illness.

But you should also prepare yourself for the possibility that the response you get may not be what you wanted or expected. Not too long ago I gave a long and somewhat detailed update on my health to a friend via text message. I was dealing with some major frustrations regarding one of my doctors at the time and I expressed how disheartening the whole situation was. His response? “Oh, I’m sorry to hear that.” Well okay, I appreciate his concern for me, but after spending so much time and energy I was hoping to get a bit more support than that. But even a flat response like that is still better than the frustrating and sometimes hurtful ones we’ve likely all heard at some point:

“But you look great!”
“You need to try [insert latest exercise trend or questionable supplements].”
“You would feel so much better if you stopped eating [insert basically everything except water].”
“Oh that’s nothing, did I tell you about the time I…”

Give them a chance to be compassionate

The next time you find yourself struggling to answer “How are you doing?” remember it’s okay to take a moment to collect your thoughts before answering. Some days you won’t feel like sharing any details about how things are going for you, even with close friends and that’s fine. Other times though, it might be worth spending some energy to give a well thought out answer. I have found that people often surprise me with how compassionate they are. Being honest and open (within reason) about how my illnesses affects me has allowed me to find common ground with strangers, develop new relationships and increase my own compassion for others.

And if your honest and open answer backfires well, the next time that person asks how you’re doing just mumble something about “hanging in there” and then go straight to gushing over pictures of their adorable dog. Cute dog pics make every situation better.

About the Author


Molly Rice is an instructional designer, college instructor, and former pharmacy technician who is currently bedbound and unable to work due to chronic illness. She is active in her church’s online ministry and several chronic illness support groups. She enjoys listening to audiobooks, sitting outside on sunny days, and cuddling with her dogs. Molly has ME/CFS, POTS, and EDS.

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