How do you answer "how are you"?

When the truth would completely alienate you (even more...) or rock someone's world- who didn't REALLY want to know... The cashier at the grocery store is blown away if I even answer the question with "tired"...
But the PC answer -"fine" is a lie...

If I said, tearfully...~ lonely and hopeless and exhausted and crazy; isolated and sarcastic and angry and sick of taking all these pills and being locked in this brain and this body;
Or if I said... Hoping I don't wake up tomorrow.
Or miserable and angry and confused and disappointed and alone
Cranky and bitter and anxious and indecisive and apathetic and sick of breathing and trying.

If you answer the question with even a kernel of truth...you have to deal with-stark silence.
Or "oh"
Or the worst: "I'll pray for you" and then I reply, "please don't"... Which always sets off an argument... (A fine topic for another day perhaps)

I don't remember ever being "fine"
Or the last time I was "good"....
But maybe I should just lie~ they don't really want a truthful answer anyway.

I'm really struggling~ maybe I should just find a more PC way to say THAT.

How are YOU?