How are you? Such a simple question. But when you have a chronic illness, the answer can be pretty complicated. The standard answer, for us stoic Brits at least, is ‘fine thanks. You?’ Or maybe ‘oh god I’m so tired’ – everyone is tired, so no one bats an eye at that. They usually agree that they, too are tired. There may be a slight unacknowledged back and forth about who is the most tired. ‘I went out at the weekend and am still recovering’ vs ‘I have triplets and havent slept in 2 years’. All pretty normal stuff.

Occasionally, people aren’t fine. Maybe they are going through a divorce. Or a bereavement. Maybe they will be honest about this, maybe they won’t – but it is generally a short lived period of difficulty where it is totally justified to say ‘actually, things are pretty shit just now’.

But how do you answer this simple question when the actual answer is never ‘I’m fine’?

The actual answer lies somewhere inbetween ‘I’ve been ill for over two years and I’m terrified I’ll never get better’ and ‘my whole body feels like it’s dying. I’ve had a migraine for 8 months solid, I want to drill into my own skull to relieve the pressure and I have no idea how to keep doing this’. Because honestly, who wants to hear that, or some variation of it, every time they speak to you? Sympathy / understanding for ill people is generally a short term thing. Once you cross the bridge into the chronic stage, it gets pretty boring constantly hearing about it. Or talking about it if I’m honest. If I answered every ‘how are you’ question with an actual list of all my physical and mental problems I would not only bore myself, I would probably get myself into a really negative place where moaning become the norm.

Having said that, I struggle with saying ‘I’m fine’ every time I’m asked, because I’m not. Not really. So where does that leave me? Honestly, it depends on the person. The situation. Whether I have the energy to have an actual conversation or whether I want to quickly move on. If someone knows about my illness it’s generally much easier – and that is one of the reasons I started this blog. I actually prefer people to understand, at least a little, of my current limitations so I don’t need to explain over and over. If it is someone who I haven’t seen in a long time who has no idea about my illness it’s a bit trickier. Do they really want / need to know? Do I want them to?

I think one of the hardest things, is an assumption, when I do say I’m fine, that I am therefore recovered. All better. Fighting fit. I have had a few conversations long the lines of ‘so how are you doing now’ ‘yeah not too bad thanks’ ‘oh brilliant, so glad you’re all better’. I’m then left in slightly awkward position – do I leave it, let them carry on with their assumption? Or do I start to clarify that no I’m not all better? It starts to come across as defensive but it feels strange to not clarify, as my illness is such a part of who I am now that it almost feels like a lie not to acknowledge it.

Maybe I am overthinking this whole thing. For the most part, in the UK at least, asking how someone is, at least in a passing social scenario, is kind of a reflex. No one really cares about or listens to the answer – it’s just what we do. ‘How’ve you been?’ ‘Yeah good thanks, you?’ ‘ Yeah not too bad’. It’s like white noise. I definitely don’t need to give an honest answer in those situations – it would be breaking the rules of Britishness.

And in other situations? I’ll stick with choosing my answer based on the person, the timings, how I am actually feeling on the day.

Just know that if a chronically ill person says they are ‘fine’ that doesn’t mean they are better. Or that they are actually fine. They might be dealing with monumental amounts of pain or fatigue. Silently questioning if and when things will ever get better. Feeling guilt and shame about how little time they spend with their kids, or how much they are struggling to do their jobs. Its just a damn sight easier to say ‘fine’.