19 Things People With Chronic Illness Mean When They Say 'I'm Fine'

When someone asks, “How are you?” the most common, socially-accepted response is “I’m fine!” For many people, it’s an answer they give without a second thought. But when you’re dealing with chronic health challenges, the simple answer of “I’m fine” may not fully reflect what you’re feeling. Actually, the real answer may be much more complicated and difficult to discuss, especially with casual acquaintances who might (wrongly) assume your “fine” means you’re feeling as healthy as they do.

So we asked our Mighty community with chronic illness to reveal what they might actually mean when they say “I’m fine.” These answers aren’t what most would expect to hear when they ask how you are — but they are real, which may help others have a greater understanding of the challenges you deal with and the support you need.

Here’s what our community told us:

1. “I always say ‘I’m fine’ or ‘OK I guess’ because I’m sure no one really wants to hear the truth. The truth is I never feel fine and my body is always waging a war inside me that feels like an atomic bomb. I have several conditions each affecting different bodily systems and I’m never symptom-free. Many people don’t believe I’m sick because I look fine on the outside.”

2. “I can mean three things: ‘I’m struggling, but I know it will pass,’ ‘I’m struggling, and if I talk about it I’ll feel worse’ or ‘I’m struggling, but I don’t want to stress you out because that will stress me out and make me feel worse.’ Generally I do want people to respect and leave me be when I say I’m fine.”

3. “I don’t really feel like telling you the truth. I am not fine. I haven’t been fine for an awful long time. I just get tired of saying what is really going on.”

4. “I think perhaps when I use it, it more often than not just means, ‘It’s not a socially accepted place for me to express how truly awful I feel and so I am putting an inhuman effort into being presentably OK.’ Or, ‘You want me to be fine so I’m fine. Fine is the only answer you’ll accept right now in this polite conversation.’”

5. “I’m coping, but my battery is losing power quickly, let’s move on and get through whatever we’re working on before apps start to crash like my vision, legs, neck, heart, etc, or worse, before the battery just drains. Then it will have to recharge overnight at least. But really, just leave it there is what we’re saying, far from fine, but my eyes are open and I’m here and could get out of bed… so really, that’s fine! Functioning at reduced capacity equals ‘fine.’”

6. “I am trying to stay positive. I don’t want folks walking on eggshells around me. I do not want the focus to be on me and my issues. I want to live a somewhat ‘normal’ life without pity. It is obvious when I am in the worst pain. That is when I stay to myself. I appreciate that others are thinking/caring about me but how about this weather we are having?”

7. “It depends on the situation. Sometimes I say it to a loved one because I don’t want them to worry. I say it when I’m too tired to answer. Many times I say it because I don’t think you truly want to know. Occasionally I say it because I am in denial and trying to convince myself I am OK.”

8. “‘I’m fine’ means today my medications are doing a pretty good job at managing my pain. No, that does not mean there’s no pain. It means that today I feel like I can handle my responsibilities with the amount of pain I’m in. ‘I don’t feel well’ or ‘This is not a good day’ means I’m on the losing side of the battle that day. No one really wants to hear the symptoms of that day. But as long as those close to me can give me a little extra grace on the ‘not good days,’ I don’t really care if they want to know what exactly is hurting. It doesn’t make it better for me or them to dwell on pain.”

9. “It depends where I am. At work it means ‘I got here, just don’t ask me how I’m going to get through the day, please don’t ask me to do anything extra.’ With friends and family it means ‘I know I’m using up every last spoon I have and probably stealing some from tomorrow, but I need to feel normal/useful, if only for an hour.’”

10. “For me, ‘I’m fine’ (on a bad day) translates to: ‘I genuinely don’t want to bring you down with the reality — because that doesn’t make anything better for either of us — and the reality hasn’t changed since the last time we spoke, so let’s focus on the positives.’”‘

11. “When I say ‘I’m fine,’ I really mean I’m in pain, I’m barely making though the day. You have know idea how I really feel. If you could spend a day in my shoes you’d see what I really go through, or I just don’t want to explain how I feel and it’s just easier to lie!”

12. “I’m really not OK, but I don’t want to be the reason you’re no longer smiling. I don’t want to bring sadness to your day or burden you with the heavy load I am carrying. So I say ‘I’m fine,’ because I don’t want you to feel even a fraction of the hurt I do.”

13. “‘I’m fine’ allows us all to pretend that things are ‘normal.’”

14. “I use it most often because there is just so much happening that I can’t even sort through it, let alone ask you to understand it.”

15. “‘I’m fine’ equals ‘Go away, I don’t want to talk to people right now.’ It’s weird because it’s not that I don’t like people or don’t want to be around them. I just don’t want to talk or really just have nothing to say.”

16. “‘I’m fine’ equals: Today is a ‘day better than yesterday,’ I can stand on my feet and I can do something despite the pain or the fatigue. The energy quickly goes away, but I could do something like a stroll, or go to the supermarket, or play with your kids if you are lucky enough to have them. Every day I don’t have to spend it on the couch or in bed with pain.”

17. “I am not fine, but I didn’t mean to let it show; I didn’t mean for you to find out. I didn’t want you to be worried about me at all… can we pretend that it didn’t happen and you aren’t worried about me?”

18. “This is painful for me to experience, but I know how painful it is for you to watch. So let’s just pretend it’s not happening so I can save one of us some pain.”

19. “When I say I’m fine… it means I don’t want to seem like a burden. I don’t want to be the one complaining about my health all the time. I don’t want you to pity me. I don’t want you to get to the point where you really don’t care and are just asking to be polite. I say it so you don’t get to the point where you don’t want to even be around me because I’m always the person with nothing good to say about my current health. I say it because I don’t want you to leave me because in sickness and in health isn’t supposed to be in constant sickness. So, I’m fine… how are you?”