In England when you say "Hello! How are you?" the answer is almost always "Very well thanks, how about you?", even if the person is not very well. This is considered polite. Other countries find this odd, and consider it lying.
I remember going in for a surgical procedure a few years back and just before the operation a non-British doctor told me "This is really going to hurt" - I was expecting "There may be some slight discomfort", which is the usual British way of saying "This is REALLY going to hurt".
I was quite concerned (i.e. British for "terrified") until they gave me the pre-med Valium.
In England when you say "Hello! How are you?" the answer is almost always "Very well thanks, how about you?", even if the person is not very well. This is considered polite. Other countries find this odd, and consider it lying.
(http://www.bbc.co.uk/news/world-europe-13545386)