Once upon a time, the standard phrase "How do you do?" was answered by custom and etiquette* with the mirroring phrase "How do you do?". Anyone who responded as if they had been asked a question was considered to be . . . Incompletely refined.
Nowadays, people complain online about co-workers (sometimes spelled cow-orkers if the keyboard jockey has read enough Dilbert) who answer "How are you?" with a long litany of woes. Others enter the thread to agree and commiserate, while some enter to say that they never know how to respond. Because they know that people are essentially saying hi, but it still feels like lying if they don't follow the strict denotation of the collected words.
People recommend saying Good Morning instead of How are you? People suggest answering Hanging in there, considering and As well as can be expected and Not bad, you?
Perhaps we need to develop some obviously contrived phrases so that everyone is comfortable giving a less than literally accurate answer, even the most non-metaphorical and pedantic among us.
Ben, stylized greetings and perfunctory generalized wishes of well-being to you.
Thank you, Mr. Wilson, and a customary acknowledgment of your existence and purported humanity to you, sir.
A verbal equivalent of a dog sniffing your butt, Fred.
Expected response, Betty.
Hijacking of standard greeting procedure to segue into a habitual litany of . . . . (maybe not that one).
* Enchantingly, the word ettiquette originally meant ticket. I discovered that while checking the spelling of the word in an actual paper dictionary, rather than hitting spell check. A benefit of actual paper dictionaries.