Alternatives to "How are you feeling?"

What are your alternatives to "How are you feeling?". How do you answer the question?

I've been going through some personal and health challenges over the last year or so, and "how are you feeling?" is the question I get most tired of hearing, and have the most difficulty answering. I especially hate the question when it's posed in text-form rather than asked in person/over the phone, or if it's the first question someone asks me.

Sometimes  I can say "today is a good day", or "this week's been good". But I get very tired about focusing on how I am feeling and of trying to put a positive light on things. Even on a good day, I end up thinking about the last not good day when I answer the question, as it's all comparative. Honestly - at this point, I don't think reflecting on it too much is very good for my mental health, and I am tired of complaining. There are some days when I just don't care to think about it, I just want to live in the moment and not be reminded I have a chronic illness.  

There are some people who ask me literally every time I talk to them. It's a chronic condition - it's honestly not changed since last time they asked. All of the people who ask it are people I do care about but are not close to- often distant coworkers, friends of the family, etc -  so I don't want to brush them off. I am glad that they care, I just get tired of answering the question!

Some seem to only want to hear "oh, I'm awesome!" and get disappointed with me if I tell them "not great" or that things aren't improving much, and some seem to want entertainment from the trainwreck of "I feel terrible", and pressure me to say how "I really feel" when I say it's been good lately. Often now I'll answer clinically. I don't really mind sharing how things are going with people or people understanding what's happening in my life - I just mind having someone "demand" the answer...

So I have been working to not ask other people "how are you feeling?" - because honestly, mostly it's pretty obvious. When my sister was in the hospital recently - i didn't ask how she felt (she couldn't eat and was in a lot of pain - did I really need to ask?). I used humour and asked how her luxurious government accommodations were, and teased her a bit, and asked if the doctors had figured out the cause yet. When I talked to a friend with health issues (who is close enough I actually feel comfortable saying how I feel) - I asked how his move was going, and how his work was going. We both later talked about how we were feeling, but it was voluntary.

So yeah - what are some alternatives to "how are you feeling?" that still show you care and are willing to listen?

I went through that after my brother died.  People always ask how you are doing.  It doesn't take more than a couple times of telling them the truth before you realize, they are just asking because it's a social convention.  They don't actually want to hear anything other than, "I'm fine, how are you?".  This only applies to more casual acquaintances of course, as you mentioned.  People close to you are probably really concerned, but they aren't the people I think you are talking about.  My assumption is that people who are really close friends and family, you can talk to truthfully.  So, my short answer, and the way I handle it, is just to say "I'm fine, how are you?".  It's short, follows social convention, and doesn't create awkwardness.

Best to you with your struggles, I hope you have more good days and weeks than bad.

Good point about the social-askers Trace. They can be annoying but I actually don't mind them too much, as most of them are content with "I'm a lot better than I was" or "There are good days and bad days, but i am doing better".  It's the people who aren't content with that answer that are challenging.

I work with a lot of people who I've spent 3-6 months with working 12 hrs a day, eating 2-3 meals a day together at some point, working really closely on "us versus the world" kinds of projects. So we are close enough that some are genuinely concerned, but we don't interact regularly. Others, I think just want to hear "I'm great, I can start working 12+ hr days outdoors in winter next week! I'll take night shift" (I've turned down three offers to do something like this in the last 2 months).  

I'm following in hopes of learning something.
I have a friend who's had cancer for the last couple of years. Sometimes he's better and sometimes he's worse. I don't ask about it unless he invites asking, we talk about our dogs, our plants, our clients, etc (just had lunch with him last Friday, and in his words we are a bunch of malevolent gossipers). I don't want to make him feel bad ("how am I? I still have cancer!") but I also feel almost as bad avoiding the topic. I mean, this is a big part of his life, it's obviously important, and the last thing I want to do is make him feel bad about talking about it.

Tereza Okava wrote:I'm following in hopes of learning something.
I have a friend who's had cancer for the last couple of years. Sometimes he's better and sometimes he's worse. I don't ask about it unless he invites asking, we talk about our dogs, our plants, our clients, etc (just had lunch with him last Friday, and in his words we are a bunch of malevolent gossipers). I don't want to make him feel bad ("how am I? I still have cancer!") but I also feel almost as bad avoiding the topic. I mean, this is a big part of his life, it's obviously important, and the last thing I want to do is make him feel bad about talking about it.

My pastor loves people, and what he does is ask, "How are you feeling Travis, no, I mean how are you really feeling." I am not sure if the written word is translating well on here, but it is a huge difference, it conveys a sense of, "I really do care". I like that Tereza, and I have had cancer for 3 years now.

Catie...my heart goes out to you. I know how you feel.

I do not harbor any ill feelings for anyone who asks such a quick answer. We live in a world where the medical profession is amazing, people get sick, and then people get better. With cancer it seems, people either get better, or they die. So I realize that is the misconception that is out there, so I extend them some grace...some slack if you will.

For the chronically ill, there is a grieving process just like the loss of a family member, because their is a huge loss. Some people grieve at different stages, and I saw this a lot when I was a Divorce Councilor at our church. People would just expect someone to "get on with their lives" and yet sometimes, it is not that easy. People who have been divorced will readily know what I mean, especially if they did not want the divorce in the first place. So a year later, some people are still hurting, but their friends feel they should have gotten over it by then.

It can be the same way with chronic illness. people just sort of expect people to get medical attention, and get better in x amount of time, when a chronically ill person may need much longer to recover.

My heart goes out to you because I am at a real low point in my life...another winter, another round of cancer, so I do understand where you might be. (That is a question, not a declaration. I would not make assumptions of where you are in this).

For me, the loss is an ability to work, and as a workaholic...a full-time farmer...I have always just worked harder to provide for my family. I cannot do that now, so I am completely humilated by this. The truth is cancer is embarrassing to have...but not providing for my family is humiliating. The difference is staggering. That makes the situation very internalized, and I cannot rise above it because the only way for me to defeat humiliation, is to have self-confidence and start providing for my family again. I try, but I cannot work, so I fall back down again in this self-defeating hamster wheel that I am on.

Unfortunately few people understand this, and so for the chronically ill, we slip into despair because no one knows how we feel. It is brutal because while we are trying to battle for our health, living in humiliation is a life that is almost worse than death.

The best thing we can do is tell people how we REALLY do feel. We have to understand that they may not understand why we are not better, but we must try, and so your post is an excellent start in understanding how to convey extended poor health.

One thing I do understand from having been in grief is that there is a difference between asking how someone is doing and being willing to listen to the answer. Like really listen. Thanks, Travis.

Some seem to only want to hear "oh, I'm awesome!" and get disappointed with me if I tell them "not great" or that things aren't improving much, and some seem to want entertainment from the trainwreck of "I feel terrible", and pressure me to say how "I really feel" when I say it's been good lately.

I feel you here. For seven years now my father has been diagnosed with a degenerative brain disease. Degenerative meaning it gets worse over time. Despite explaining this to many people (including much of my close family) people get upset at me when they ask me “how’s your dad doing?” and hear it isn’t getting better and there’s no fix on the horizon. Most people’s brains aren’t wired to understand an illness that doesn’t have a curable path and their brains melt down when they hear that sometimes things just don’t get better. So like others have said already, I just lie to them and say he’s doing fine.

As to alternatives to how are you feeling? I think the best way is to re-focus the subject of what you’re saying back on to yourself. What are you prepared to do? Asking someone how they’re feeling puts all the onus on them. Something like I’m here to listen if you need to talk switches the subject around. Another thing I’ve noticed as I’ve gotten older is that vague, negative-leaning questions like “how are you feeling?” end up in boring conversations that neither person really enjoys. Questions like What are you most excited about right now? offer far better conversation paths.

As always - really thoughtful answers from everyone :)

Tereza - I think Travis is right, and intentions tend to come through. I have a few friends who really actively listen, and retain information between conversations, and follow up with what I have said (ie, if I say I have an appointment next week, the next time we talk they ask how my appointment went). I feel like those friends are the ones I am most comfortable talking with. I have a relative with cancer, and there's not much I can say, but I've been sending her cute memes and pictures way more frequently than usual. She has told my mother that she appreciates it, because she feels remembered. It takes maybe 2 min out of my day, or less?

Travis - I've seen some of your posts on your struggles recently, and you and your family are definitely in my thoughts. I have a lot of empathy for you, as a fellow recovering workaholic who will likely never be able to go back to what I used to do. I think the North American sense of self is really tied up with work ethic, and it's a challenge to separate your sense of self-worth from your employability.  I can't even imagine where you might be, because I am lucky that I don't have dependents that I am responsible for, and although my condition may worsen, it's unlikely to be fatal. I think some of the hardest to understand, but strongest grief (and it is grief) with long term illness comes from not just the illness, but from the way it forces you to abandon or change your long-term plans.  I think you've had to deal with that grief repeatedly, and I would find that pretty demoralizing. I am very glad to hear you have a pastor you can talk to, and family who care, and I hope you are able to remind yourself that they care about you not because you are a good worker, but because you are a good person.  

Kyle Neath wrote:I feel you here. For seven years now my father has been diagnosed with a degenerative brain disease. Degenerative meaning it gets worse over time. Despite explaining this to many people (including much of my close family) people get upset at me when they ask me “how’s your dad doing?” and hear it isn’t getting better and there’s no fix on the horizon. Most people’s brains aren’t wired to understand an illness that doesn’t have a curable path and their brains melt down when they hear that sometimes things just don’t get better. So like others have said already, I just lie to them and say he’s doing fine.

As to alternatives to how are you feeling? I think the best way is to re-focus the subject of what you’re saying back on to yourself. What are you prepared to do? Asking someone how they’re feeling puts all the onus on them. Something like I’m here to listen if you need to talk switches the subject around. Another thing I’ve noticed as I’ve gotten older is that vague, negative-leaning questions like “how are you feeling?” end up in boring conversations that neither person really enjoys. Questions like What are you most excited about right now? offer far better conversation paths.

Kyle - I think you hit on exactly why this question makes me uncomfortable. A) People don't understand that things don't ALWAYS improve, and B) focusing on "how are you feeling" may end up as a negative conversation, and puts the onus on the person to explain themselves. Sometimes negative topics are necessary/cathartic but that negativity really does need to be balanced with positive interactions too. And your right about the "I'm hear to listen" or other offers of help. They are really rare, but they are very valuable to hear.

So I guess my question has become - how can I express care for a person (who is ill, or who isn't ill), allow them to complain if they need to, and yet still leave the door open to just talk about happy things if the person wants to?

I think I am going to try "So, what's new with you?" , "Anything big happen since the last time we talked?" - and then, maybe specific questions if they reveal something. Hopefully that's more open-ended and gives the other person the opportunity to choose what to talk about. I may also try asking "any news from your doctors?" if it's someone who's condition is not static.

I have read this thread (with interest) and have had several thoughts/suggestions, which I offer here in case they are helpful.

I agree that there's a difference between an acquaintance asking 'how are you feeling?' (almost in a thoughtless, kneejerk reactive way) and those close to you who the question is authentic and searching.
It's usually fairly easy to distinguish between the two....but the tone or the look in the eye is a giveaway too.

I realise that when undergoing a difficult time that it is hard and draining to try and search for a positive spin in reply too.  However, addressing those who don't really want to know how you truly feel, you might:-

- just shrug and offer a half smile (implying it's a somewhat dumb question!) i.e. you are not obliged to say anything

- if possible, make light of it and - to "how are you feeling?"  say "compared to what!?"  (courtesy of a Grouch Marx quip!)
 
- if something new has occurred, you could offer that.  At parties/socials, people often ask 'how are you' but I like to ask 'what's new?' (if I know them).

- if you can see they are well meaning, you might lightly touch their shoulder and offer something like "getting there" or "it takes time..." or sigh and say 'thanks for asking' with a half smile or a knowing look

Whilst I don't wish to analyze/judge the predicaments shared, I know (first hand) how easy it is for depression (brought on by external events or otherwise) to so easily slide into degrees of more intense depression that can be hard to come out of.  It might go without saying but it would be beneficial to be vigilant and to take action if need be....

🌈

I *try* to just ask things like, 'what's up', 'how's it going', or just not even ask, and skip straight to 'hey! You've been on my mind! Wanna see what I've been up to?' In my own physical chronic pain, in my grief over losing my dad one year, then my mother in law, the next year (2 of my very favorite people, besides my hubby & our kids), and a critter or more, per month for the last 11 months straight(including baby chicks, due to illness, predation, accident, etc), one of the things I've learned is that often, the best way to help me feel better, is tell me about what you're doing! Give me something to focus on, even if only for a few minutes, besides my own baggage. If I'm up for talking about me, and my stuff, and I sense you're open to it, I will bring it up. It's nice, at times, to be able to simple put my baggage down, and not bear is weight, for a while.

"How are you feeling? / How are you doing?"

I sometimes give quick responses like:

"Today? Maybe a 6.5 out of 10."

"Well, the glass is half full, so that's good."

And the classic black humour response: "I'm livin' the dream."

Personally, I have always felt this to be a comment of social "grace" rather than a question seeking an honest answer and, frankly, a phrase that should be abolished amongst "acquaintances". Frankly, most don't care and others are simply gathering gossip.

When an acquaintance asks, my response is to ignore/skip over the comment entirely, or shrug and say "...meh" and move on with what others have suggested "whats new with you?".

If it is a true friend, they KNOW what my life is like; if I am not in the mood to discuss it honestly I simply say "...yeah, not talking about that, today.  SO what's up with you!", or "...not a great day/having a good day, what's up with you?". This effectively refocuses the conversation, while not dismissing their inquiry, it clearly shows my health today is not something I am up for discussing.

Yes, some do not get the hint; those who push get the blunt "not discussing THAT today", and a reiteration of "SO, what's up with you/what can I do for you, today?". If they continue to push they get " you really want to know? Today sucks, and so did yesterday and all last week, I choose to NOT focus on that. SO, what's up with you?".

My friends learned quickly that when I redirect with "What's up with you" or "What can I do for you?" means I am likely feeling fragile and really would rather focus on them, and the reason they called.

I think this phrase has become a meaningless social convention and if you actually answer truthfully you make them feel uncomfortable. Somehow this question has become ingrained as a greeting, and in my opinion is no longer, truly, a question, nor do they WANT an honest response/answer!

I say, let's abolish the phrase entirely!

Yeah the 'how's it going?' that most say as a casual greeting is overused, so one option is to turn the reply into a form of personal amusement:

"how's it going?"
"Every day my enemies become more fearful of my approach!"
"Every minute, the weekend gets closer!"

"what have you been up to?"
"WHY!? WHAT DID THEY SAY??" (looks around suspiciously)

"how are you?"
"Somewhere between better and best."
"I can’t really complain, but I'll still try!"
"Medium-well."

And for those who are hoping you'll break down: "how's it going?"
"At minding my own business? So much better than most people."

In my personal quest to keep it neutral at the outset of a conversation, I often ask:

"What's new with you?"

"What's goin' on?"
(Not in a, "hey, I'm confused or alarmed" kind of way, but in a cheerful, expectant kind of way)

"Any highlights from yesterday/last week/since I last saw you?"

I tend to break the ice discussing events in general, then ask about those events without prying into too-personal a space for the circumstances and/or subject. Also, these sorts of openers help in developing some context for creating follow-up questions during our conversation.

I find most social graces an annoyance, but practicing them in a non-invasive, non-leading-question kind of way opens the door to deeper questions and chances for me to - as someone mentioned already - really listen to the other person.

Regarding the askers (how are you feeling?), over time I have become less bothered by the ones who ask but really don’t want to know than the ones who ask and then are  either 1) dismissive of the answers (oh, it’ll get better, oh, you should do. …), or 2) think they are offering empathy but don’t know what that means (i know just how you feel because I ….)


So here’s the rant. I have multiple sclerosis. Its a very weird and mercurial disease. It cannot be cured (yet).  It is managed.
MS happens when our immune systems decide here and there that the myelin sheath around nerve fibers in our brains and/or spinal cords are the enemy and chew holes in them (aka lesions). Our bodies do not know how to repair these holes. Think of an electrical wire with a break in the insulation. Sometimes it works , sometimes it doesn’t. Sometimes when it doesn’t work its no big deal. Sometimes it burns the house down.    

So, it is with us for life. If we are lucky we die of something else. I was not diagnosed until I was 53, and looking back, my doctor and I believe the symptoms started maybe 5 or 6 years earlier.  So as people with MS go I am really lucky.  The form I have is primary progressive. My symptoms do not abate, and slowly worsen.  But I still walk unsupported (though not always gracefully) and can still pick up a 40 lb bag feed or salt or whatever. So I don’t look like I have a chronic, incurable  disease.

Back to the point. I don’t mind people asking me how I’m feeling. I don’t even really mind if they don’t pay attention to my answer or appear that they only  asked to be polite. I have to offer grace on this. I’m sure I have done it myself over the years when my own problems (working too hard, trouble with a spouse, money troubles, whatever) made it hard for me to hear, or to be honest really to care about the answer, but yet I had an ingrained impetus to ask.

What REALLY gets me is certain other responses I get when I actually explain what I’m feeling. If its with someone I have never discussed this condition before I also talk about how different it is for everyone with MS because symptoms depend on the location of their lesions and the severity at any given moment can depend on what else is going on (like, how hot is it? Did leg spasms keep  me up all night — for me, they only happen in the night).  Many people do not disclose that they have MS for a variety of reasons., Most often  it is because they fear for their  jobs, but there are many other reasons. One young man in my support group talks about how strong and fit he always was (and still is most of the time), but to him having MS means he is weak. He believes if he discloses his MS others will also think he is weak and treat him accordingly. He thinks his wife should leave him because of this. This man is still in his 20’s. As I said, I am really lucky.  Anyway, since I don’t mind disclosing, I offer a offer a few  sentences if it comes up in conversation because its a condition that people don’t know much about (scientists included!).  I know I didn’t, and I have a degree in biology.

Back to the point: what bugs me is not that people ask, even if insincerely, but rather two categories of responses:
1) they tell me how to fix it or at least manage it. This happens more than you think. They tell me that sticking to the Wahls diet (though typically they don’t know its name) will cure me. Or that I should walk a lot (because a celebrity from the 80s or 90s whose name escapes me managed his MS by walking a lot and he was fine. What’s wrong with this? I doubt that I have to explain that here but I can’t help it: it a) assumes that I am ignorant of these things or if not, closed minded about them or I would be following them already and be feeling all better, b) they can save me from myself and my ignorance/ muleishness, and c) they are so smart and are so happy I gave them this chance to perform this identity (ok, point c was snarky and purely gratuitous).
2) the empathy that isn’t empathy: they know exactly how I feel because sometimes they are forgetful and sometimes they get more tired when its hot and if they don’t drink enough water they also  get leg cramps (btw, different from leg spasms. Ask me how I know).  Etc.  Many people do this not cynically, but because they are are trying  to show they are hearing me, that they get it because they can connect it to their own experiences. They want to be with me on this without conveying  pity (which is not empathy, nor even sympathy), and I appreciate that. But they don’t know, they can’t connect, and moreover, it is not necessary to try. The best response they could  give (assuming they are interested) is something like acknowledging how that might be really frustrating, or really hard to get used to, or whatever. Empathy is acknowledgement of the existence of feelings, experiences, etc, of the other. Acknowledging that they are real. Maybe that if the had those experiences they might feel the same way.
3) one-upmanship (more common a response than one  might think): if you think that’s bad, then ket me tell you about …..Some people responding this way may be trying to cheer me up (though I do not generally present myself as needing that) and they are not callous, just misguided. Others are just ultra competitive and any response to the how are you feeling question might have elicited that kind if rejoinder.  

If you made it thus far (I know, I do go on endlessly. I’m happy that its easy for you to just look, think oh her again, I got the point two thousand words ago, and that you are not trapped with me alone in an elevator stuck between floors), I’ll leave you with this:

I’m pretty sure I have at some points in my life, probably a lot more often than I would like to think, committed all of the failures listed above. I’m pretty sure that  mostly I thought  I was being helpful but was too ignorant to know I was just trying to show I was smart. Also that I really, genuinely wanted to make it better and was offering what I had.  (I still suffer from this kind of hubris - that it is my job to make things better and if I don’t know how, i can find out, though by now I’m better at recognizing when it rears its head so I can nip it in the bud).  So, I do try to forgive it when I can. But, if at that moment I am rankled and am unable to be my best self, here’s what I do:
I say,
—-maybe you have MS too.  You might think about talking with your doctor about that. I had no idea that these different  things I was experiencing could all have  same cause..
—- thank you (and move on as quickly as possible
—- I’m sorry to hear that. That must be really frustrating/painful/scary ….. and move on
— and when that doesn’t work, the blank stare generally does
And if I have a need to express displeasure that is so strong in the moment that my adult self has left the room leaving me behind, I infuse the same words with a sarcastic voice learned in childhood and then castigate myself later.  Or not.

In a Nutshell:
For those really wanting to show empathy after asking “how are you feeling?” I offer this  tip  which you may or may not find useful: ask questions. Do not provide answers unless your advice is asked for. Questions that show you really do want to understand what you are hearing. By asking those kinds of questions, the person knows you care enough to spend the time to really understand their experience.  You have already made the person feel better by virtue of feeling heard. Its as simple as that, and  IT IS THE MOST GENEROUS THING YOU CAN DO.  This can be hard. Americans often are knee-jerk well-meaning  fixers.  I tend to be one of those; having MS has taught me a lot.  But do this - the question thing, the not fixing thing - work on this only if you you really do want to understand. For its own sake. When you’re really not that interested? It happens to us all. We are not infinitely interested in sll thins and all people. The solution is simple:  just don’t ask how they’re feeling. Find another socially appropriate catch phrase, like  “hello, its good to see you.” It will serve both parties well.

I have found that most people are fully expecting a cookie-cutter response such as "Good, how about you?". They seem to already have their response queued up and ready to go, and they likely just want to talk about their own lives, so it's fun to trip them up. I tend to respond to the initial question with "Moderately well". Most of the time, it is greeted with confusion, amusement or some blend of the two. That moment of awkwardness is a perfect opportunity to carry on with whatever I was doing and leave them to figure out what just happened.

Depends.  I seldom ask the question socially.  I answer it with a neutral “as good as can be expected.”   With someone with chronic health problems I take a more functional approach by asking something like “any special plans for the day?”

In my experience, no one really wants to know. My daughter's current boyfriend remarks that her depression was not attractive, despite him having experience with this issue. I'm pretty sure that depression is not meant to be attractive, it just is. She's frustrated because if he's struggling with her at this point, he is not going to be able to handle the anniversary of her son's death or his birthday that are coming up. I'm not looking forward to the fall out from that.

The one that I find least helpful is, "Are you Ok?"

It always feels to me that the person asking feels that they are more important, and the only valuable thing is to make sure that the sick/depressed person doesn't annoy the asker by giving the wrong answer. The only important viewpoint is that of the person asking, not of the sick/depressed person. "Don't upset the asker's point of view by explaining what you're really dealing with.  Your job is to say that you are ok. " Backwards and more likely harmful than helpful.

John S
PDX OR

I am a huge fan of clear communication. It is very disappointing when people ask questions they don't really want the answer to. It is also very common, so it is beneficial to learn to suss out when the question(s) "how are you feeling/doing/ ..." are really seeking specifics, or just the common phrase for "hello".

For me my first task is to check (with myself) if I have the bandwidth to listen and HEAR the answer to any question I ask. If I am in a hurry, or have other things on my mind I want to remember to not try to have a conversation I am not present for.

My second task is to recognize I have choice in how I answer questions I am asked. If I want to share how I am feeling, I can do such, and risk not being heard. I can share my feelings in a short sentence or 2, and that increases the chance I will be heard. I can ask the questioner if they are willing to just listen and not problem solve if I share how I am feeling/doing. And if I am not wanting to focus on the stuff that is harder, I can dredge up what IS working in my life/in the moment, and share that. It is actually MY choice to be swamped in what is not working rather than what is, and being asked helps me practice focusing on the positive. That said, I think it is in the interest of society to share BOTH what is working/enjoyable, and that which is not working/painful. How we share these things can impact whether another is willing and/or able to listen and hear us; not 100 percent, of course, but it can improve our odds of being heard. In the end, we can hear ourselves if no one else does, and give ourselves the empathy (whether over celebration or mourning) we long for.

John Suavecito wrote:The one that I find least helpful is, "Are you Ok?"

It always feels to me that the person asking feels that they are more important, and the only valuable thing is to make sure that the sick/depressed person doesn't annoy the asker by giving the wrong answer. The only important viewpoint is that of the person asking, not of the sick/depressed person. "Don't upset the asker's point of view by explaining what you're really dealing with.  Your job is to say that you are ok. " Backwards and more likely harmful than helpful.

John S
PDX OR

I always give the answer they least want to hear, in detail. If they didn't want to know, they shouldn't have reminded me that I only got 4 hours of sleep because of ptsd nightmares and being hyperaware of every little noise in the night.

I was brought up that when I saw someone I knew I would ask how they are.  It is just being polite.  Maybe it is a southern thing since I grew up with a southern father.

I probably usually say "How have you been?" or "How are you doing?"

Usually, when I call our daughter I ask "How are you doing?" as she has more on her plate than a person her age needs.

"How are you feeling?" does sound a little more personal.

No matter which greeting is used I would probably say "I am doing great, how are you?"

This is accurate to what I've heard others say privately:
https://i.imgur.com/W1Dxzv6.mp4
(short video clip with captioning of what some men mean when they say "I'm all right")

When I'm being socially conventional and need to start a conversation, I usually start with "How's it swinging".  That's usually off-beat enough that it doesn't require the other person to divulge anything and sometimes adds a bit of levity to the start of the interaction.

My usual response to "How are you doing" is either "mediocre" or "fair to middlin' ".  The first one allows them to think a bit, the second is just pure fluff.  

I'm a bit of a social butterfly though and use humor a lot, so these approaches might not work for everyone.

I've always considered tone of voice rather than words. There's a world of difference between "Hey, how are you doing?" when said casually, tone swinging up and down, signalling that it's good to see someone and "Hey. How are are you doing?" said sofly, head tilted forward and down when you really want to know how someone is feeling. The first I know that the speaker is just saying hi, that the correct response is "Good, how are you doing?" before you launch into further small talk. The later is when someone actually wants to know if you're struggling, if you need help. Now, if I don't want to go into what's going on in my life, I'll just brightly reply "I'm doing good, how about you?" and the person usually gets I don't want to talk about it. And if I'm the one asking someone else how they're doing/feeling, I try to read their body language beforehand and when they respond I try to follow their lead.

It took me awhile to learn this - I lean towards the neurodivergent and the ins and outs of conversation is something I only figured out with practice. And I know for some people, figuring out tone and body-language is very hard. But yah, for me it's all tone and body language, not necessarily words.

Yes, tone of voice, inflection, is so very important to me too.  I have had more misunderstandings, hurt feelings, anger, resentment, you name it, when try to communicate in the written word.  I agonize over the perfect words, taking 10 times, ever 100 times as long, and still there are problems.  
The recent social climate (extremism, hyperbole, prickly subjects) has exacerbated all communication, written and verbal.  I try to be extremely thoughtful and kind. considerate of others, to my own wear and tear.  Then the one time, in literally 1,000 times, I am in extreme pain due to my disability, or really stressed out, and because of backed up traffic at the light, I inadvertently block the ability of oncoming traffic to make that left turn into the driveway of that house, I get honked horn, middle-finger and screamed "@#^$!!!" at.
I hope we can all re-set ourselves to a kinder, gentler age, perhaps kindergarten, just long enough to remember the "golden rule."  Just because we don't hear it on television or see it on social media, doesn't mean we can't do it until it starts to spread there too.
The nicer you are the harder it is for someone to continue acting ugly.  If you don't "engage" the monologue will eventually end.  If not, simply walk away.  It is not always easy.  It's quite often difficult.  Don't give up!

Mary Pressley wrote:Then the one time, in literally 1,000 times, I am in extreme pain due to my disability, or really stressed out, and because of backed up traffic at the light, I inadvertently block the ability of oncoming traffic to make that left turn into the driveway of that house, I get honked horn, middle-finger and screamed "@#^$!!!" at.

Ouch. I've been on both sides of this coin. Only once was I the screamer, though. Due to my fibro & lupus, I'd been on an ssri for over a year, and - without notice - permanently lost access (a potentially lethal problem). My doctor switched me to gabapentin, and we discovered the hard way, that in my case, with that particular drug, the "may cause irritability" warning would have more appropriately been worded "may cause homicidal tendencies". It was summer, and everyone's windows were open, the woman in the oncoming direction didn't pull the 20ft forward that she easily could have, traffic backed up behind the 3 cars (I was driving the 3rd car) trying to pull left into the only entrance to the drugstore parking lot, and somewhere behind us, people were slamming on their brakes, tires screeching, much cussing behind us... I lost it. I yelled at her, cussing, for being totally oblivious (and yet, all those other cussing, braking people were just as oblivious, or they wouldn't have all been panicking...). She moved up, visibly shaken, traffic moved again, and I pulled into my parking spot, and burst into tears. John went in, while I called my doctor, and told her I could NOT take another dose of that stuff. I felt myself getting downright MEAN, and couldn't seem to control it. I was terrified I'd actually end up hurting someone.

My take away from that was that sometimes, the person who is being the asshole is as much a victim of the circumstance as the person they're mistreating. I saw what was happening to me, and couldn't manage it, until I got off that stuff. I can't help wondering how many folks are having similar difficulties, and don't recognize it might be medically based. It can be a lose-lose situation. So, I pose the question, how can we gently help someone aggressive, who may be having a similar difficulty? Is it even possible, if we don't know them well? Or is "A gentle answer turns away wrath" our only hope?

Instead of asking open-ended questions, which are awkward, I sometimes greet with something like "Hey, great to see you. I hope you're holding your own, more or less? (Like the rest of us?)" [with suitable body language/gestures]

This is easy and casual, and gives them the easy option to say "yeah, we've had a few challenges, but all in all we're hanging in."

Because everybody has had a few challenges. I think my approach acknowledges that fact without putting people in an uncomfortable spot.

I have this very funny neighbor who will just go on and on if you ask them an open ended question like "how are you." On the one hand I think she's lonely and also kind of just has one of those personalities where you like to complain. On the other hand I think it's nice for me to at least give her a little space to talk each time we see each other.

An underestimated aspect of relationships is how much energy they take. And one only has so much attention and energy to give. With my homestead, 3 kids, husband, siblings, parents, part time work, I feel my attention stretched thin. So if I have had a particularly taxing day I just let myself avoid people like my neighbor. No reason to overtax oneself at the detriment of your sanity!