How to Respond to the Dreaded Question, ‘How Are You?’

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by Jennifer van Amerom |

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¿Cómo estás? 你好嗎 Ça va? How are you?

With the holiday season upon us, people are getting together, hopefully safely, considering the persistent COVID-19 pandemic. While I always enjoy seeing friends and loved ones, I find it uncomfortable when I’m asked difficult questions like, “How are you?”

While the phrase has become a standard pleasantry, and one of the first we’re taught when we learn a new language, how should someone with an incurable rare disease answer?

The first impulse might be, “I’m good. Thanks for asking.” But that can feel like lying, both to the person asking and the person answering.

Often what comes next is, “You look good!” or “It’s so great to see you healthy!” Yikes. Now I’m even further into the lie.

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Another dilemma is that social gatherings often involve alcoholic beverages, which are a bad idea when I’m on medication. So, how should I handle being offered a drink? If I say yes and nurse the drink all night, someone will eventually call me out. If I decline, I’m suddenly explaining that things aren’t great with my body.

I don’t want to bring negative energy to a party, and I would never overwhelm someone with the tough reality of my neuromyelitis optica spectrum disorder (NMOSD). Instead, I usually take the easy route by smiling, accepting a glass of wine, and hoping no one notices when I ditch it. While I know my friends and family love me, they won’t ever understand the stress of living with a rare autoimmune disease.

10 alternative responses

Following are some of my favorite responses to the common and difficult questions and comments those of us with rare diseases often hear at a party or other social gathering. When asked “How are you?” I might respond:

1.I’m really happy to be here.’

If I’ve decided to attend a gathering, then I’m probably excited to see the people there. I can guide the conversation and talk about how lovely the host’s home is, for example.

2. ‘I had some really great moments this week.’

This response usually leads to follow-up questions, but at least it lets me focus on positive moments in my life. Note, however, that if you use this response, you should be prepared to offer examples.

3. ‘Incredibly good-looking!’

Sometimes the best way to answer is with humor. Be careful about using this one if you’re single, though. You don’t want to give someone the wrong impression.

4. ‘How are you?’

Redirecting a question with a question is a classic distraction technique. Plus, it’s nice to hear about others first. Most people can’t resist the opportunity to share about themselves, especially at a gathering where people are meant to socialize.

Next, in response to the comment, “It’s so great to see that you are doing better!” I might say:

5. ‘Thank you. I just bought this dress/shirt/jacket.’

I try to look good when I’m attending a function, because I know it’s the exterior that people see. But it can be easy for others to mistake this effort for how I’m truly feeling inside. This is a polite way to shift the focus to a lighter topic.

6. ‘Thank you. I’ve been trying to get more sleep/eat better/meditate.’

Maybe I do look better than the last time they saw me, but I don’t want to draw a comparison. Instead, I can introduce a new topic, such as sleep quality, new eating habits or recipes, or things I am doing to improve my mental health.

7. ‘I’m having a good day.’

Only use this response if it’s true. It’s a good way to politely remind someone who knows enough about my health challenges that things are always day to day with me.

Finally, in response to the question, “How’s your health?” I can say:

8. ‘It’s the same. Thank you for asking.’

I keep my response short and direct so that it doesn’t overwhelm either of us. If they really want to know, they’ll ask follow-up questions. If they’re just being polite, this response will end the discussion.

9. ‘I’m focusing on a new project at work that I’m excited about.’

While this doesn’t answer their question, it does give them the impression that I’m well enough to be pursuing other initiatives.

10. ‘Under excellent care.’

Unless they work in the medical field or are a caregiver or patient, most people aren’t familiar with complex medical jargon or rare diseases like NMOSD. What they really want to know is if I am in a better place mentally and physically, so that they can worry less about me. This response reminds them to leave treatment to the professionals while eliminating any guilt they may feel.

What are some of the difficult questions you encounter at social gatherings? What are your go-to responses? Please share in the comments below.


Note: Neuromyelitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Neuromyelitis News, or its parent company, Bionews, and are intended to spark discussion about issues pertaining to neuromyelitis optica spectrum disorder (NMOSD).


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