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“How Are You Today?” and Other Hard Questions

Each time I encounter another person I face a choice: should I pretend to be the person I think I’m supposed to be or should I be authentic? Whenever we talk with another person, we are consciously or unconsciously determining how “real” to be in our communications.  This is evident in the seemingly harmless question “How are you today?

Sometimes the answer to that question may be easy; it may be one of those days where everything seems to be coming up roses, and it, therefore, feels natural to provide a positive response. However, there are many days when the answer is far more complicated. Perhaps we’re going through a divorce, getting over an illness, worried about a friend or relative, grieving a loss, or facing enormous pressure at work. We may not be doing that great, but we’re not going to get into those details with everyone we come into contact with. We have to determine in each encounter whether to give the perfunctory, “I’m fine, how are you?” or to be honest that it’s not the best of days.

The invisible/chronic illness barrier: How much do we communicate

For those of us living with a chronic condition such as rheumatoid arthritis/rheumatoid disease [RA/RD], the seemingly simple question “How are you today?” becomes even more loaded. Not only do we have to decide whether we’re going to be superficial or whether we’re going to be honest, we have to decide whether to risk the judgment and misunderstanding that often form a barrier between those of us with chronic illness and those without.

For example, if a supervisor or colleague asks how I’m doing, and the true answer is that I’m in a lot of pain and/or am very fatigued, I worry that if I share this information s/he may assume that my job performance will be impacted and see me as less valuable.

If others ask how I’m doing, and I share that I’m in pain due to RA/RD, there is a host of unhelpful responses I may get. They may tell me about their tennis elbow, attempting to form a connection but actually indicating they have no understanding of the difference between an injury and an autoimmune disease. They may ask if I’d like an ibuprofen, not understanding the extent of my pain, the number of pills I’ve already taken and the sophisticated medical treatments I’m on. They may share a “cure” they’ve read about or heard from a friend of a friend, not realizing how much energy I’ve put into trying to find answers in managing this condition. Or they may express their disbelief that I could have a disease with a statement such as, “But you look so good” or “But you’re too young!”

Sometimes I don't have the energy to dispel myths around my invisible autoimmune illness

Depending on how much the pain and fatigue have ground my spirits down, I have varying levels of energy to take in unhelpful responses. While I do believe it is important to spread awareness about autoimmune conditions, as these common misconceptions will only persist in the absence of education, there are days where I just don’t have any extra energy to dispel myths. There are also people that I don’t feel safe enough with to able to trust that sharing I’m having a hard day won’t be held against me. In our go-go-go society that prizes “having it all,” admitting vulnerability isn’t always welcome.

Therefore, each time I’m asked, “How are you today?” I find myself running multiple assessments simultaneously. I'm asking myself, "Do I have the energy to handle an unhelpful response? Can I trust this person to know what I'm going through? Is it safe to be vulnerable?" as I determine my answer to this routine question. I'm constantly weighing whether the pros outweigh the cons of being authentic.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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