“I get anxious about looking anxious”: a qualitative study of anxiety, depression, and workplace productivity among professional workers

Background and objective Anxiety and depression are increasingly prevalent in working populations. This secondary analysis of qualitative workplace interviews develops a theoretical model of how these conditions interact with workplace structures to affect professional behaviour and productivity. Methods Semi-structured interviews were conducted with 189 professionals across multiple sectors in the United Kingdom between January 2023 and February 2025. Using reflexive thematic analysis, I identified 38 participants who, against pre-specified inclusion criteria, explicitly reported living with anxiety, depression, or both, and analysed their accounts in depth. Results Six interconnected themes emerged: (1) the disclosure dilemma, (2) identity-threat vigilance, (3) compensatory masking, (4) the productivity paradox, (5) managerial mediation, and (6) intersectional compounding. These themes are integrated into the Concealment–Disclosure–Adaptation (CDA) Model, which theorises that workers with anxiety and depression navigate a cyclical process of concealment, selective disclosure, and behavioural adaptation shaped by perceived psychological safety and intersecting identity characteristics. Conclusions The CDA Model extends existing frameworks by foregrounding the dynamic, context-dependent nature of mental health management at work and its bidirectional relationship with productivity. The findings imply that encouraging openness about mental health at work is insufficient without managerial practices that favour practical flexibility over evaluative scrutiny, and without equity-informed support for workers facing compound stigma, for whom disclosure carries the greatest risk.