Macro - Different actions when holding down and releasing a key

Hi, I am looking for advice as to how to setup the following macro:

When I press down a mouse button 5, I would like the macro to:
Press Q down (0 sec)
Press Q up (0 sec)
Press Left Mouse Button down (hold)

When I release it (press up mouse button 5), I would like the macro to:
Press Left Mouse Button up (release)
Press Q down (0 sec)
Press Q up (0sec)