Is the dread maybe to do with the fact that a birthday marks yet another year over - but you feel you have accomplished nothing and all that year has been wasted? That time is going by and you can't live up to it?
That's how I felt and I never told anyone when my birthday was as I felt so wretched about life going past while I did nothing and had nothing.
But after reading a self help book ( I used to jeer at the thought of these) Heal Your Life by Louise Hayes I found that I could let go most of the self hatred and doubts that had been with me ever since I could remember. It helped so much with giving me a sense of self worth.
That and following my instincts in moving to a new location and then finding a part time job which led to full time work has seen my life change so much for the better.
I still have anxiety and depression but I can deal with it. I even went to university and gained my degree while working part time, it was hellish at times but I did it. You just have to believe you can do it and make yourself take the first step - and then keep doing it.
Birthdays don't worry me now, I feel I have accomplished what I wanted to do and I am proud of myself for coming through. OK a bit the worse for wear and tear and I do have bad times and fall to pieces but there are the good days to balance those bad times out.