How to Respond to ‘How Are You?’ When You’re Not OK

If you would have seen Nora McInerny at her 35-year-old husband’s funeral, you might have thought she’d never looked better. That was the consensus “according to so many people,” she says, in part perhaps because she’d lost weight after barely eating for months—but also because she kept insisting she was absolutely, completely, totally fine.

That, of course, was a lie she was telling herself and others. “I felt the worst I ever felt, and I also felt nothing at all,” she says. “And what did I do? I just stood there and told everyone that I was fine, and I changed the subject. I told everyone I was fine to the point that everybody in my life believed me. ‘She’s doing great! Look at her! Look at her Instagram! She’s doing wonderful.’”

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McInerny—author of books including It’s Okay to Laugh (Crying Is Cool, Too) and No Happy Endings—hosts the podcast Thanks for Asking (previously known as Terrible, Thanks for Asking, a response that’s always on the tip of her tongue). Within six weeks in 2014, her father passed away, her husband died of brain cancer, and she miscarried her second child. It makes sense, then, how much time she’s spent pondering what to say when someone asks you how you are, and the truth isn’t “good.”

What’s the right response? We asked McInerny and other experts how to figure out what will feel best.

Flip the script

About a year ago, Jennifer C. Veilleux set a goal for herself: She would try never to answer “I’m fine” or “I’m good” if she wasn’t really feeling that way. When she catches those words rolling out of her mouth—which still happens occasionally—she corrects herself and tells the other person she’s trying to avoid sticking to the script we all generally expect.

“We know what we’re supposed to say: ‘I’m fine, how are you?’ Yet that’s often not true,” says Veilleux, a professor of clinical psychology at the University of Arkansas, Fayetteville, who studies emotion. “It’s now become a habit to try to reflect and say, ‘Well, how am I doing? Am I doing OK, or am I not? How can I answer this question in a way that reflects the reality of my moment?’”

Veilleux wants to avoid “expressive suppression,” or a tendency to hide feelings from other people. “It’s holding up a smiling mask, when inside, things are crumbling,” she says. Research suggests that suppressing emotions is linked to increased anxiety, depression, and stress, as well as poor relationships. “Emotions are built to be expressed—that’s one of their functions,” she says. When people get too used to holding them in as a way to cope or manage their feelings, “it’s associated with a ton of psychological problems.”

Since swearing off “I’m fine,” Veilleux has found that people react “really well” to her more honest responses. “I think we as human beings strive for connection and for belonging—it’s a core human need,” she says. “So to get a real answer to that question feels refreshing.”

First, gauge someone’s capacity for the truth

As a child-life specialist and therapist, Kelsey Mora specializes in supporting families impacted by illness, grief, and tragedy. “In other words,” she says, “often families who are ‘not OK.’”

It can be helpful to assess how ready the person asking you how you are is to hear the messy truth, Mora says—especially if they don’t already know what you’re going through. You might phrase it like this: “Are you prepared for the honest answer?” “Do you really want to know?” Or: “Do you want the long or short answer?” The point isn’t to shield or protect other people’s feelings from reality, she adds. It’s to ensure they’re capable of providing you with the support you need.

McInerny thinks of it as seeking conversational consent. Sometimes she’ll text her best friend and say: “Can I call you and have a full mental breakdown?” The answer might be “of course”—or it might be “certainly, but in 15 minutes.” “Then I don’t have to feel angry that she didn’t answer,” she says. “I don’t have to feel disappointed.”

Keep these handy responses close

Depending on how much you want to reveal, there are a variety of ways you can truthfully answer when someone asks how you’re doing. It’s not just what you say, but how you say it that matters. For example, Veilleux sometimes responds: “Honestly? I’m on the struggle bus right now—this week is a lot.” She says it in a positive tone and laughs in a “you know what that’s like” kind of way. People tend to commiserate, she’s found, and chime in: “I hear you! This time of year is rough.” “It’s honest, but it doesn’t require a lot of disclosure,” she says.

Veilleux also keeps these responses in her back pocket:

“I know I’m supposed to say I’m fine, but I’m not actually fine right now.”

“I’m upright—that’s about all I can say.”

“Getting by …. barely.”

“Honestly, not that great.”

“I’m having a hard time right now.”

Each response is truthful, while inviting the other person to ask what’s going on—without making them feel obligated to do so, she says. “You’re either going to get the interested, compassionate, ‘Tell me more; you can dump on me’ response,” she says, “Or you’re going to get the ‘Oh, bummer’ response, where the person is like, ‘I don’t want your feelings right now.’” When the latter happens, you can try again with someone else who might have more capacity to listen, Veilleux adds.

If you’re ruminating over what to say, keep in mind that the honest answer matters more than the “right” one, says Tyler Coe, who created How Are We Today?, a PBS sitcom that aims to help people talk about mental health more candidly. For a long time, Coe kept his experiences with bipolar disorder bottled up, never revealing how he was really feeling.

Now, when people ask him how he is, he pauses, assesses how he actually feels, and then answers truthfully. That might mean saying “I’m having a rough day” when he’s with a friend, or letting them know: “I’m not good right now, but I’m working on it.” He might also issue this warning: “Hey, I’m about to free-flow right here, but I’m just going to honestly tell you how I’m feeling.” If he’s at work, he might opt for “I’m managing.”

“The key is not performing ‘fine’ when you’re not,” he says, while acknowledging that it probably won’t feel natural at first. “I’m truthful about how I am, but it’s taken me my whole life to get to this point.”

Even when you’re not, “fine, thanks” sometimes does the trick

If you’re checking out at Target and the cashier asks you how you are—and the truth is that your life is in shambles—it’s probably best to simply say you’re fine. The same goes if you’re passing a colleague in the hallway and only have 30 seconds to get wherever you need to be.

There are other situations when it might make sense to stick to the script, too: If you’re talking to someone who has dismissed your feelings or been hurtful in the past, for instance, Veilleux says.

If you simply don’t want to talk about how you’re doing, you can protect yourself by saying “I’m OK,” Mora adds. She also likes this way of setting a boundary while still being authentic: “Honestly, it’s been tough, but I’m not really up for talking about it right now.” That can work well when you are, for example, about to give a presentation at work and can’t afford to show up off-kilter. “It’s OK to say whatever you need to in order to function,” she says, as long as you find a way to let out your feelings at some other point.

Remember: most people care

When McInerny was struggling—yet telling everyone she was fine—she assumed they would be able to read her mind and just know how she was really feeling. “I thought that was a perfectly reasonable thing to expect,” she says. “I’m lying straight to your face, but I want you to somehow intuit that I’m lying to you.” She believed that by downplaying her grief, she was doing the right thing: “What is our national anthem in America? It’s ‘you’re fine, pick yourself up by your bootstraps; anybody can do it,’” she says. “If you can’t, then it feels like a personal failing.”

Yet if you keep concealing the truth from people, they’ll believe you when you say you’re OK, she says—and you’re not doing yourself or others any favors. Looking back, McInerny regrets forcing a smile instead of leaning on her friends. She hurt people who wanted to show up for her during her darkest days, she says, and had to work at repairing those relationships.

“I took away the opportunity for them to be the kind of friends that they are, and that they wanted to be to me,” she says. “That’s what it means to be loved: If you knew someone you loved was struggling, wouldn’t you want to know the truth?”

As you consider how to respond when someone asks you how you are, and you’re not OK, McInerny urges: “Give people a chance, and let them love you.”

Wondering what to say in a tricky social situation? Email timetotalk@time.com