Note that there are two verbs in Spanish that mean “to be:” estar and ser. However, estar is used in this context because it implies a more temporary state, whereas ser is used to talk about a permanent condition or state of being. Because verbs are conjugated to agree with the pronoun, you can leave off the pronoun and the sentence will still mean the same thing. The pronoun is inferred by the conjugation of the verb.
It also doesn’t hurt to use this phrase when talking to an adult you’ve never met before, as it conveys respect. You can drop the pronoun usted and simply ask “¿Cómo está?” It means the same thing and will convey the same level of respect.
To make this question informal, ask “¿Cómo estais?” (koh-moh ehs-tah-iss) Keep in mind that in some Spanish speaking cultures, it might be considered more polite to ask this question of each person in the group individually, rather than addressing the group as a whole.
“¿Qué pasa?” (keh pah-sah) “¿Cómo va?” (koh-moh vah) “¿Qué tal?” (keh tahl) “¿Qué haces?” (keh ahs-ehs)
“¿Qué onda?” (keh ohn-dah): Mexico, Guatemala, Nicaragua, Uruguay, Argentina, Chile “¿Cómo andas?” (koh-moh ahn-dahs): Argentina, Spain “¿Qué hubo?” (keh ooh-boh): Mexico, Chile, Colombia “¿Pura vida?” (poo-rah vee-dah): Costa Rica
If you’re not familiar with the person, you might instead ask “¿Cómo se siente?” (koh-moh say see-ehn-tay) It’s the same question, but using a more formal pronoun.
After you say “bien” (bee-ehn), always follow up with “gracias,” (grah-see-ahs), which means thank you. Even if you’re feeling absolutely terrible, it’s not really considered appropriate to come right out and say it. You might try “Bien. . . ¿o te cuento?” (bee-ehn oh tay coo-ehn-toh) which means “Good. . . or shall I really tell you about it?”
You can also say “así así (ah-see ah see) which means basically the same thing.
The flow of conversation is similar to what you would have in English. Someone says “hello” and asks how you’re doing. You would likely respond “Fine, and you?” Follow the same social cues in Spanish as well.
If you’re feeling a little better, you might reply “Me siento un poco mejor” (may see-ehn-toh oohn poh-coh meh-hohr). You could also add a description for how you feel, particularly if you’re not feeling any better. For example, you might say “Me siento mareado,” or “I feel queasy. "
