About the "How are you?" question

What do you think about the "How are you?" question?

I, personally, do not like this question and I have never liked it.

I do not know what to answer.

Also, a lot of the time, I think it is expected just to give a positive answer, but I often feel awful to say "Fine!" simply to be polite if I am not fine. 

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  • What would you make of the following exchange, between me and a neurotypical friend of 20+ years?

    Friend: How are you?

    Me: A bit tired.
    [this is my code to acknowledge that I've been very depressed for several days, missed a lot of sleep, and apologise in advance if I nod off during the film we're about to see. I don't expect sympathy, I just want to give an honest answer and get on to the next bit of the conversation. But before I can ask the question back:]

    Friend: Yes, I know, the weather's been terrible.

    I'm then confused by what seems like a complete non sequitur (unless the weather's been keeping people up - it hasn't been that bad).  It's not like we don't talk about personal stuff, although I feel like I do far more listening about her work and relationship problems and probably any discussion of mental health is off-limits.

    I'm wondering about another poll about why we don't like being asked 'How are you?'  Something like:

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