It does work, but it's harder to pull off because you need to give a short, relatable reason along with a negative (if not immediately obviously).

If you reply that you're stressed but you leave it at that, the other person won't know if they should ask you about it or not. If they do, they might be getting into a much harder, longer conversation than they were expecting to.
But if they don't ask, then they will feel like they're being rude, because you're supposed to help out other people if they're not well, so either way it probably won't be a pleasant experience for them.

If you offer something like "stressed, finals are coming up", then they can keep the conversation going by asking you about it, or they can just move on by wishing you luck or something to that effect and move on.