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How to respond to “How are you?”

“How are you” is considered a polite question to ask in almost every situation. When you have migraine, it can be difficult to answer in a socially appropriate way. Most of us don’t want to lie, but we also know that the person probably doesn’t want to hear the honest answer. Even “OK” often doesn’t seem like the right response.

With many years of practice, I’ve come up with some standard answers. Which one I use depends on how I feel physically, if I’m mentally alert and able to engage in conversation, and who I’m talking to. The pattern is usually the same – a vague initial response followed by a specific question of the other person. People love to talk about themselves and will almost always answer direct questions. They rarely even notice that you didn’t really answer the question and have redirected the conversation back to them.

Here are some of my responses to “How are you?” and some useful deflecting questions.

With friends and family who genuinely want to hear the answer:
“I’m breathing.”
“I’m here.”
“I’m standing.”
“It’s been a tough day/week/month.”
“Terrible.” (Then I say, “But I don’t want to talk about it” or “Do you mind if I vent?”)
“I’m good today.”
“Do you really want to know?”

With work or social acquaintances or family members who don’t want to hear the truth:
“It’s been a week.”
“Today’s been alright.”
“I’m looking forward to seeing [Movie Title] next week.”

In a passing conversation at the dry cleaner or coffee shop:
“Oh, you know.”
“It’s been one of those days.”
“I’m ready to put my feet up and watch some TV.”

Deflecting questions:
“What are you up to?”
“What are you excited about these days?”
“What’s been the best part of your day/week/month?”
“What did you do today?”
“What’s the most interesting thing you learned last week?”
“What are you looking forward to this week?”

There are hundreds of ways to respond to “How are you?” How do you reply? Looking for more suggestions? See ChronicBabe founder Jenni Prokopy’s 100 responses to this question.

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.


  • bluebird
    5 years ago

    If I am able, I might say- “Today’s a good day” or “Right now, I am glad to be out and about”. This is often followed by a version of “You mean you are Still having Migraines?” If I am in educating mode, this is a great opportunity. If not, a simple “Yes” -“It has been a long time since I have seen you- I only add “How are you?” if I can really listen.

    At home I try to be radically honest. It seems to help me to engage those closest to help notice signals of a shift and prepare them and myself for a change in plans. Sometimes my spouse will notice flatness of my face, voice or furrowed brow before I do. Sometimes it helps to let others know “My concentration is going. I am feeling irritable & increasingly yucky. Sorry, I am going down. Can we talk/do this later?”

    I know I am in Migraine Zone when I feel like I can’t even attempt to account for myself. I feel too tender to even speak to a well meaning other.
    Awareness of this signal sends me into retreat, so I try to let my partner know…”Going down. See you later”. It’s an agreed upon Code that works to sustain feeling connected when I just want to dissolve! With those simple words, I implicitly ask for back up when I can’t even think of what needs to be handled, and express an affirmation that this episode won’t last forever.

  • The Migraine Girl moderator
    5 years ago

    For me, it depends on who’s asking and how much energy I have for a response. Sometimes I am guilty of glossing over the truth when a loved one is concerned, because it pains me to see them hurt for me when I tell them how bad I feel. If I see an opportunity to educate someone about the complexity of migraine, I might answer honestly, saying anything from “I can feel a migraine coming on, but so far the headache hasn’t started, I’m just a little dumber than usual!” to “I want to apologize, because I’m totally out of it. I am feeling really awful today, but I do want to catch up with you later when I’m functioning again!”

    In sum: it totally varies. 🙂

    -Janet G., “The Migraine Girl”

  • Katie M. Golden moderator
    5 years ago

    Such a good topic Kerrie!
    My typical line is that at this very moment I feel well enough to be out of the house, so let’s have a good time!

  • Sonya
    5 years ago

    I’ve read 9 responses and like all of them I struggle with this too. I REALLY like your response best! I’ll be using it!

  • Nancy Harris Bonk moderator
    5 years ago

    Sometimes my sarcasm gets the better of me.

    I’ve replied with “I’m able to sit up and take nourishment” that usually stops people in their tracks!

  • jo17151
    5 years ago

    I use deflecting questions a lot. Much depends on the situation and who’s asking. . . .
    “I’ve been up and down” – I use when I’m having a bad day and people who I’m not at ease with ask (ie. those who say something inappropriate if I let on it was not a good day)

    “I’ve had a real bad few days, but feeling better today”

    “The pain has let up, but I still have ‘migraine brain'” Those who now me really well are aware that during the last phase I’m supper ditzy – last week I tried to give my friend directions to my home and if she’d followed them I don’t know where she’d have ended up! She’s very understanding and commented “I’m glad you aren’t driving”.

    When I am having a good day, I hope to be asked the question so I can say “I’m having a good day today”.

    This is a very helpful article as are the replies. One can never have to many coping mechanisms.

  • Sherri
    5 years ago

    I too struggle with this question. I have struggled with anywhere from 8 – 16 migraines/month since I was a child, so when people ask “How am I?” I know they don’t really want to hear the truth. My standard responses are really basic…”I’m here”, or “It is that kind of day.” It is really hard to be happy and perky and upbeat when your head, neck, eye or all of the above are throbbing and sore – then throw in the nausea and it gets really dicey trying to answer that question. Thanks for the great article – I’m glad I found this site!

  • msruff
    5 years ago

    This is a question I struggle with all the time. After over 15 years of answering “migraine,” or “a lot of pain,” I want something more positive, especially with clients, but it’s not always easy to think quickly enough to get something out. Sometimes I just say, “Oh, another migraine, but I’ve been working and have a question about …”. Actually, I like my boyfriend’s response: “Awake, alive, and breathing, not necessarily in that order.”

    I have people, including my boyfriend, who get offended if I lie or try to put off the question, so those I answer as truthfully as I can. Otherwise, I respond with something vague and follow up with a “can I vent a bit?” Usually in the venting, I find that positive I was looking for and try to focus on that.

  • jo17151
    5 years ago

    MsRuff, I like “can I vent a bit”. I’ve had chronic migraines for 4 years now. I’m down to about 1 a week with treatment (but about once every few weeks get caught in a loop of one attack after another for a couple of days that take another couple of days to recover from).

    Recently my counselor told me to “stop telling lies and be honest” this really took me back and I was quite offended. Till I started to pay attention to how often I would try to keep my migraines from my partner and others close to me. It really never went well – others can’t “see” the migraine and I’d just present as being in a nasty mood . . and I’d be frustrated because I’d expect them to read my mind.

    I’ll now say something like “I need to lay low till this migraine lets up a bit” or if they catch me at the end of an attack I’ll give them a bit of warning about my ‘migraine brain’, yet not dwell on it and that seems to be going better for all concerned (saying “fine” and acting like a b-word just wasn’t going well). Your comment “can I vent” will definitely be one I’ll use.

  • Star71
    5 years ago

    I reply w/ “I’m here.” It’s the most polite way I know how.
    Like today I’m at work w/ a horrible migraine. I had a bad attack last night and of course it’s carried over through today.
    I’m dealing w/ noises, smells, people, and worst of all fluorescent lights. And it’s killing my head twice as much…
    I’ve had chills and sweats within a 2 hour period… I’m miserable, but to be polite I say “I’m here.”… And with a smile. .. A weak one, but it’s still a smile. 🙂

  • MigraineSal
    5 years ago

    One of the best ones I use is . . .

    Wearing and Chafing ( with a rye smile on my face )

    . . . people usually politely laugh as they haven’t got a clue what I am talking about and they tend to walk away contemplating on what it actually means !

  • Jules2dl
    5 years ago

    My 92 year young Dad is blessed with great health for his age. He’s slowing down physically and has his aches and pains; thank God nothing serious.
    He always replies to “How are you?” with a hearty “Wonderful! Just wonderful!’ no matter how he is feeling. He claims that after hearing that response from him people tend to refrain from barraging him with a list of their own complaints.

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