-Fair to middling
-Hanging in there like a hair in a biscuit
-Finer than frog hair
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-Fair to middling
-Hanging in there like a hair in a biscuit
-Finer than frog hair
The horrors persist, but so do i.
I'm a big fan of this one, I started using it as a mantra when I got sick of "this too shall pass"
Monty Python also has a good response:

"I'm not sure"
It's rarely all bad. Then that would be simply the answer. The problem is that it's often complicated (not the emotional capacity of a teaspoon, for those who get that reference) and idk how to summarise that into a single feeling so I literally don't know what the answer is and so that's when you get an idk from me
If it's just a pleasantry by some english person (in my language this isn't a standard question a stranger or customer support will ask you) then I'll probably pick a random euphemism
From Germans I've learned that they say "muss", meaning must. Like, you must get on with life but not because you seek out what you're going through but because life doesn't stop. At least that's my working understanding of this deceptively simple word
In German, we say "shitty would be bragging".
Beschissen wär geprahlt!
The one who can not cope with this answer should not ask!
Sometimes I ignore the question and just move on in conversation. Most people don't even notice because they're asking out of habit, not to actually ask you how you're doing.
I'm here is an answer. If you deflect you also get your point across.
Something similar. I Normally go with "I'm breathing" if I really don't want to answer honestly and saying "good thanks" feels like too much of a stretch lol.
I find most people kind of laugh the answer off and continue with conversation from there
Treat it non-literally. Say 'How's it going?' which turns it into a greeting rather than a question.
I'm awake, but I'd rather not be.
In Finnish we have a phrase "ei kurjuutta kummempaa" which is said in a happy, jolly way and its usually accepted as "not great but I don't want to expand on it." It translates to "nothing worse than misery."

Really though, it depends entirely on the person. With my partner I will try to give the most complete answer I can, with friends and coworkers it depends on how close our relationship is. With strangers it may be a completely perfunctory answer to a completely perfunctory question, especially if I'm not up for defending a non-perfunctory answer, but I like to keep my answers real when I have the spoons for it.
just say "Life,,, ya know"
If they are only being polite they'll answer "for sure" and thats it.
If they really care and want to know theyll ask more and then you can go into more detail.
Brought to you by "protocols autistic people have to memorize" lol that being me
I find this question quite fascinating: Culturally, there are countries where this gets asked indeed as a form of greeting, not a genuine question.
In Slavic countries, I feel like if you get asked this question, it's generally considered to be of genuine interest, and you'll get a genuine reply. Nothing offensive or informal about saying "Things are bad." or "I feel bad.", or any variant of such.
This might be my perception however, and feel free to correct me. I myself think that if someone asks how I'm doing, I have no need or responsibility to "remain positive/pleasant".
I live in the US where it is just a greeting, but grew up in a different culture where it is almost always taken literally and isn't something you ask a stranger. I tend to answer honestly because I want to normalize not being fake polite and I almost always have some bullshit to call out. If you can find something to complain about that other people also hate, it's a great way to bond around how shitty the world can be. :D
“Well enough” if you want to be genuine, but brief and convey that things are not aces.
But usually just mirroring “How are you!” in the same tone as the first part of the greeting establishes that it is a ritual, not a question.
"up and not crying"
...that is, if I'm not crying.
"Still kicking but not screaming!"
"Good, you?"
"I've been worse"
"I am vertical."
“Eh, been better.”
I feel like that response is real without oversharing, and invites someone to respond however they want. If they care, they can ask what’s up, or they can just say, “aw bummer man, hope it gets better for you,” or whatever.
Not dead yet
"Great!"
"Alright, you?"
"Living the dream."
"Another day in paradise."
"One day closer to death."
Depending on my mood
My go-to is the ol Lebowski quote, "Strikes and gutters, ups and downs"
"Its going" gets the message across. Kind of shit, but time passes.
"Hangin' in there" is what I generally use when I'm not fine but I know it's just a greeting. It conveys that things are less than fine, but not by how much, and that I'm still functioning.
Some other, more flippant ones: "As well as can be expected", a shrug and a "meh", "Too early to tell" (if it's first thing in the morning / just arriving to work), "Sitting up and taking nourishment", etc.
You can even skip answering at all, and move directly to the response greeting, "Hey, how are you?"
It depends on who's asking.
Generally I like to tell what's on my mind. Or, if I say stuff is fine, I'll explain what I've been doing lately.
I'm not a person who avoids difficult topics so it's kinda natural for me to answer "more honestly".
"Eh, tired.", usually.
People tend to get it. They're probably tired too.
-- Frost
I'm usually asked this at work, so my go-to response is, "Well, I'm here." Which most seem to understand.
"Better than I deserve"
just say "not well" if you are not well. if they dont care, then what do you care what they think.
personally i find it degrading to pretend everything is fine if things are not fine.
"Not too bad."
This is going to come off with a heavy “if life gives lemons” vibe, but over time it does work. Where I went to college, there was a day every year, I think during Fall or Spring, where everyone greeted everyone. Nobody made a big production about it, just a simple, “hi” or “what’s up.” Weird thing is it had a tendency to keep going beyond the day. Most people only did it on the day, but a surprising number of people kept doing it outside of that. Including me, eventually! I still make an effort to be nice to people, and I trace it back to that. No, it doesn’t magically make my day better, but it’s one nice thing that happened. Plus, over time it helps me see/appreciate even small positives, which helps keep me from getting too weighted down by the bad stuff.
Don’t mean to trivialize the bad stuff in your life, OP. I do hope you’re able to manage it, and not let it beat you down. When I started college, I was a pretty negative person. While I wouldn’t call myself “sunny” all these years later, I do see a big difference in my general outlook compared to younger me.
Adding: not saying anyone shouldn’t be genuine, like plastering on a big psychotic grin and reply with, “I’m great!” Maybe just responding with something like “g‘morning,” “hey”. Even, “Been better, but thanks for asking.”
I am visibly disabled. the last time i was asked some version of "hey, how are you" that was not in a clinical situation was over a decade ago. people use different phatic expressions because they fear I might answer honestly.
my usual answer is "i'm alive/here. that makes it a good day" which people take as an optimistic greeting but folk who know me well, uh
Took me years to realize that the "correct" reply is to ask the same question back, not answering.
But my go-to phrase when having just gotten out of bed, headed for my shift was "too early to tell"
Just yeah, not bad like the rest of us do.
"I'm here"
People don't talk to me much.
"Fine" tone of voice fills in the rest.
Hanging in..
"Getting by" or "carrying on" assuming I don't want to invite deeper discussion of my issues.
“I’ve been better” is my go to
I like to use lines from Country + Western songs.
"I'm another day older and deeper in debt." 16 Tons.
"I killed a man in Reno, just to see him die.' "Folsom Prison Blues.'
You get the idea.
"Vertical."