[SilasX]

Am 36yo American, lived here all my life. It still feels dissonant not to give a substantive answer to "how are you".

[thaumasiotes]

I have a big problem with this as well. Once, while studying in Shanghai, an (Italian) classmate asked me and, seeing my usual struggle to respond, remarked "this question is always so difficult for you".

[SilasX]

I had a co-worker who got a real kick out of asking me a similar question and seeing me struggle.