"How are you doing?" is a common daily question in the rural Upper Midwest culture I call home. It's like a greeting of hello. You hear it in our small towns, passing by in the grocery store or after church on Sunday. Most answers are "good" or "busy." And then we all go on about our days.

We walk away not saying how we're really doing, whether it be full of positive news or a struggle we're facing.

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I attribute this in part to the stoic German and Scandinavian ancestors who came before many of us. They were surviving, trying to make it in a new country. You just put your head down and work. You don't talk about struggles. You quietly push through them. You don't share your proud moments. It's the old way and has been passed down for generations, creating a culture of silence at times.

In rural areas, we say we know each other. But we do not truly know one another. We tend to only talk about topline topics, the weather being most popular. When someone shares about a struggle on Facebook, we might write a comment of "I am praying for you." But then we see the person at the grocery store, we don't ask about the struggle, and some of us are reminded we forgot to actually pray for them.

The way things are or have been is not working. More technology, more methods of communicating, and yet we are not sharing are true selves.

Why do we suffer and struggle in silence? Why do we not share our proud accomplishments? Yes, work hard. Yes, keep going. As my mom says to me, "Do the next thing." I agree. But I do not agree with not sharing how we're doing. It means talking to our spouse, investing time in listening, carving out purposeful time with our trusted friends and loved ones. Share your struggles. Share your best work. Speak out and do not stay silent, no matter your circumstances.

And if you do not want to know how a person is doing, don't ask. If you don't have time to listen, don't ask. I look around with no medical expertise and think we're not good. We're not only busy. We're struggling. We're lonely. We're overwhelmed. We're also joyful for new opportunities and proud of our latest accomplishment or of our kids' work. Positive or negative, share about it.

According to the nonprofit Mental Health America, one in five adults in America has a mental illness. That is 43 million Americans. Yet 56 percent of people with a mental health condition do not seek medical treatment.

I have said many times to close friends and family I wish we could talk about mental health and mental illness like we openly talk about a cancer diagnosis. But we don't. A majority suffer in relative silence.

I definitely make a few friends in my silent culture uncomfortable when I share in private conversations how I am really doing. I am not afraid to talk about the struggles. I focus on my faith, family, marriage and career. The rest fall into place around me. When I carve out purposeful time for friends, I refuse to sit around and not dig into what is really happening in all of our lives.

Talking and listening will not cure mental illness. Seek professional help for mental health conditions. But we do all need a support system for good times and difficult journeys.

Even with professional help, we need to open up to those closest to us. Be prepared for a real, raw answer the next time you ask, "How are you doing?" Be prepared to listen.

I've started asking my closest friends and family, "How are you doing? I mean how are you really doing? The real version." Then I wait. There's usually a pause and a longer answer. I am not a solution. I am not a medical provider. I am a friend, a listening ear. I walk alongside friends in the good and bad times and am grateful for those who walk alongside me. We all can be that friend, and we all need one in return.

Pinke is the publisher and general manager of Agweek. She can be reached at kpinke@agweek.com, or connect with her on Twitter @katpinke.