How to answer 'How Are You?' when you're not OK

When someone asks how you are, the default answer in everyday life too often lands on “fine” or “good,” even when you’re not feeling that way. Nora McInerny, a writer and podcast host who has publicly chronicled grief after a cascade of losses in 2014—her husband’s brain cancer, her father’s death, and a miscarriage—has become a touchstone in conversations about what to say when the truth isn’t cheerful. She has described standing at her husband’s funeral, appearing composed on the outside while feeling fractured on the inside—and realizing that maintaining the façade did more harm than good for the people who wanted to help. Her experience illustrates why a growing chorus of researchers and clinicians are encouraging people to rethink the script they use when asked how they are doing.

About a year ago, Jennifer C. Veilleux, a professor of clinical psychology at the University of Arkansas, set a personal goal: stop answering “I’m fine” or “I’m good” when she wasn’t. She says that this habit—often learned as a social norm—creates a pattern of expressive suppression, where people hide their real emotions behind a smiling mask. Research links such suppression to higher levels of anxiety, depression, stress, and strained relationships. Since changing her own responses, Veilleux has found that friends and colleagues react with openness and empathy, and people respond more honestly in return. She notes that people crave genuine connection and belonging, and a real answer to “how are you” can feel refreshing rather than intrusive when delivered with care.

First, gauge someone’s capacity for the truth. As a child-life specialist and therapist who works with families impacted by illness and grief, Kelsey Mora emphasizes the importance of assessing how ready the other person is to hear the whole truth. She suggests phrases like: “Are you prepared for the honest answer?” or “Do you want the long or short version?” The point is not to shield others from reality but to ensure they can offer the support you need at that moment. McInerny describes a practical approach she uses: conversational consent. Sometimes she texts a close friend to ask, “Can I call you and have a full mental breakdown?” The answer may be “of course” or “in 15 minutes.” The goal is to prevent the disappointment that comes from expecting someone to read your mind or to know you’re not OK without you saying so.

Keep these handy responses close. Depending on how much you want to reveal, there are a range of truthful yet manageable ways to answer. Veilleux sometimes says: “Honestly? I’m on the struggle bus right now—this week is a lot.” She finds that such honesty invites solidarity rather than judgment, and it’s enough to signal a listener to lean in. Other ready-to-use lines include: “I know I’m supposed to say I’m fine, but I’m not actually fine right now,” or “I’m upright—that’s about all I can say,” or “Getting by … barely.” Phrases like “I’m having a hard time right now” can invite curiosity and support, while still setting a boundary about how much you want to share in the moment.

There are moments when sticking to a shorter reply is appropriate. Veilleux notes that in everyday encounters—checking out at a store or passing a coworker in the hallway—sticking to “I’m OK” can be a protective boundary if you’re not up for a longer conversation. Mora adds that you can flag the boundary in a way that preserves authenticity: for example, “Honestly, it’s been tough, but I’m not really up for talking about it right now.” The objective is to function in the moment while postponing a deeper disclosure for a time when you have more bandwidth and support. It’s also reasonable to opt for privacy when past interactions have left you feeling dismissed or harmed by someone.

Remember: most people care. McInerny reflects on her own miscalculation during her darkest days: she assumed people would intuit her struggle and read between the lines without her saying the truth. That assumption eroded the opportunity for friends to show up as she needed. She has since urged others to allow the people who love them to respond with care, reinforcing the idea that asking for humanity—and accepting it—can reinforce bonds rather than fracture them. The bottom line, she and the researchers emphasize, is that the honest answer matters more than delivering a perfectly polished script.

For those navigating tricky social situations, the guiding principle is to honor your own needs while inviting appropriate support. If you’re unsure how to proceed, start with a clarifying question to your listener to assess their readiness to engage with your truth. If you choose to share, do so in a way that leaves room for support rather than judgment. And when you’re the listener, remember that asking something as simple as, “Would you like to talk about it now, or would you prefer a different time?” can make the difference between feeling seen and feeling overwhelmed.

The overarching message from McInerny, Veilleux, Mora, and others is clear: conversations about mental health and bereavement rarely have a one-size-fits-all script. People vary in their capacity and their willingness to listen. The practical guidance is to lean into honesty when you can bear it, to set boundaries when you cannot, and to seek out the audiences—whether friends, family, or colleagues—who are prepared to listen with care. In doing so, the goal is not to expose your vulnerabilities for shock or pity, but to invite the kind of connection that helps you move through the difficult moments with support rather than isolation. If you’re unsure where to start, consider approaching the question with a plan: identify how you’re feeling, decide how much you want to share, and choose a listener who has demonstrated the capacity to respond with compassion.