I’m starting to dread when someone that doesn’t know me too well asks me:

How are you?

It makes me wince in some small way every time I hear it, to the point that some days I wish that people didn’t ask me. It’s simply too difficult and loaded a question to ask me these days.

This is because it’s a question bundled with too many social conventions and niceties. In many cases it goes far beyond someone genuinely wanting to know how you are and is more of a convenient by-word to start up a conversation.

Chronic illness isn’t convenient, and it can’t always be explained by a glib reply.

Let’s deconstruct the question and the ways you can answer it.

Quickly and easily

As time goes on with a chronic illness you get to know who asks you genuinely and who’s making small talk and wants to move on. I’ve learnt to gauge who I can trust with a genuine answer. Generally speaking I find it best to move on from the question (from most people) with a suitably vague answer. This particularly suits when dealing with colleagues that you don’t know too well at work or elsewhere or people unaware of your illness, particularly on the phone.

I normally pause a little (weighing up what to say) and this occasionally gives a clue that I may not be totally forthcoming, if someone picks up on that, they get all the chronic illness kudos they can from me.

How honest you are depends entirely on who you are speaking to, the context of where you are talking and how well they know you and your illness. Generally answering too honestly to someone you don’t know will make them uncomfortable, and possibly provoke some more questions that you may not necessarily want to answer.

This is because social conventions almost encourage people to keep talking or asking about something they don’t completely understand – often out of nervousness and a genuine (but sometimes misguided) desire to try to understand.

As a good colleague of mine reminded me the other day, I just have a different sort of normal to everyone else. So sometimes we can get away with the outright lie, we do feel “fine” sometimes – comparatively – even if our “fine” could flatten someone not used to it.

Be open

I try to be as open as I can with my family, good friends and immediate working circle. This has been a slow, steady process of information sharing as I try very carefully not to overwhelm any one person with too much information. Naturally it’s quite simple for us living with endometriosis to understand what a chronic illness is and how it effects us.

It’s quite tricky for someone else (even someone we’ve known for years) to take in all of that information in at once. That we have pain and difficulty that will never leave us, that we could be like we used to be one day and laboured the next.

Now many years into endometriosis I have a very good understanding of those who I can answer the question to honestly – and even those who can tell without asking, from my posture, my face, the strain in my voice. Those wonderful people who just know without words or movements. Those who strike the right balance between normality and support.

Be it from the cup of tea without suggestion, or the cushion on the seat, or the quiet removal of what I’m carrying. Every quiet realisation means a great deal to me. It’s an affirmation of true understanding.

Practice and patience

I remember being very kindly offered some time with a Health and Safety Executive respesentative through my employer. This person specialised in working spaces, seating layouts and monitor setups in offices, and I was very open with them about my working life, my chronic illness, and what my employer had done (which was a great deal) to improve my comfort in the office.

I expected them to be extremely mindful of chronic illness, given their role. To be completely prepared for the information I told them about my chronic fatigue and chronic pain, but I could tell that they were slightly taken aback by the detail of my illness. That even in the context of a review of my working circumstances and health they weren’t prepared to hear such things from a young and well-looking young lady.

It just goes to show that sometimes even someone that you can completely expect to cope with the true answer to “how are you?” can still find it complex to take in.