The question, "How are you?" is often used as perfunctory greeting, a throwaway question, or an obligation that doesn't actually request a true response. There are only a few responses that are expected (and accepted):
Good.
Fine, thanks!
Well, and you?
It's for this exact reason that, when we're trying to really connect with another person, "How are you?" isn't a good question. Our instinct tells us: this person doesn't want the true answer — they want the surface answer. Our muscle memory jumps in, gives the default and appropriate response, and we miss a moment of connection.
For you might be feeling 'good' or 'fine' or 'well,' but also simultaneously 'anxious' and 'scared' and 'confused' and 'lonely' and 'excited' and 'hopeful' and 'grieving' and 'loving.' This is just how we are wired: a 2015 study found that people frequently experience positive and negative emotions at the same time.
If you want to know how someone is really doing, the key lies in that small word: really.
The next time you want to connect, try just adding one word to your question: "How are you, really?"