How are you? Really?

How often do you say 'How are you?' out of habit?  How many times has someone asked you the question without waiting for the answer?  How do you answer when you're not actually fine or good or great or okay?

Can we ask the question differently?  Should we ask How are you feeling? How are you, really? How are you on a scale of one to ten?

It's an important question.  We need to ask it.  We need to answer it.  We need to hear the answer.  We need to have our answer heard.