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Millennial managers have seen enough. They’re taking ‘sanity days,’ joking about who’ll be laid off next and trying to stay out of the ER from stress

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“I ended up in the ER,” says a senior communications director in his late 30s who works in the public sector, describing waking from a nightmare with chest pains, pins and needles in his left arm, and being short of breath. He was convinced he was having a heart attack. The director, who requested anonymity given the public-facing nature of his role, told Fortune that a doctor diagnosed him with a panic attack, while his therapist suggested it was related to burnout from stress at work, while stopping short of making that diagnosis.

“Essentially, he said, ‘Your org has culpability, they have done this to you.’”

As Fortune reported in July, millennials broke the managerial tipping point in 2025, as the cohort aged roughly 29 to 44 has displaced Gen X as the largest percentage of leaders in the workforce. But what does it mean for “the burnout generation” to be the ones in charge? They’ve found themselves leading in a climate dramatically different than the one their own bosses walked into—often with minimal mentorship or guidance along the way.

Over the past three months, Fortune has heard from more than a dozen millennial managers, coast to coast, private-sector to nonprofit, and found a once-optimistic cohort now sandwiched between old-guard expectations, a daily onslaught of modern pressures, and the promise and peril of new work trends. Several of them, like the comms director who visited the ER, requested anonymity to speak freely about their own struggles and those of their colleagues and organizations.

Some common refrains emerge. Millennials entered the workforce seeking to work for empathetic organizations and leaders who would care about them, and now they’re on the receiving end of a heightened version of those same expectations from Gen Z subordinates. They also revealed a crisis of mentorship, as few of them could reference healthy models of leadership or specific training regimens that equipped them for the responsibilities they have. On the front lines of what Glassdoor chief economist Daniel Zhao describes as an ongoing burnout crisis, millennial managers are forging new models of empathy and flexibility, but often at significant personal cost.

‘Not very well prepared’

“Millennials as a generation are not very well prepared to take over and … be in charge of all the workforces,” said Andrew Rotz, a financial wellness advisor at Fruitful, who contrasted his experience with his service in the U.S. Navy. As a junior officer in the military, he said, you get “hands-on, on-the-job training” to prepare you for being “in charge of larger and larger organizations.” In the private sector, it’s more like, “Oh, you’ve been here a while, you’re doing a good job, here’s a promotion. That doesn’t instill confidence in the rest of the organization.”

Rotz, who is in his late 30s, added that he’s not saying the military is a perfect model, citing “internal politics,” among other things, “but it’s much better thought out than any civilian process I’ve seen and mostly gets it correct.”

He urged employers to increase workplace transparency, as he has seen major decisions being made too often based on subjective and half-baked perspectives, or a more fully-thought-out process not being shared widely enough. In one instance, he described being responsible for hiring and training a team within roughly 45 days of his own start date with “zero insights into our objectives, metrics, goals” because he wasn’t privy to the strategy behind the org’s decisions. “It ended up being just blame, stress, and lack of accountability” when it became clear that the brand-new team wasn’t going to meet its deadlines. Rotz added that he was being activated from the Navy Reserves to Active Duty for a while and would likely be deployed overseas when this article was published.

Numerous interviewees described abandoned ambitions, or a reluctance to climb higher. “I have 0% interest in moving up,” said the comms director who visited the ER. “I manage with empathy and flexibility but above there’s still a stiff upper lip,” he said, describing a scenario where middle managers who care about their staff get caught in the middle on an “old-style attitude” and a younger cohort who unanimously reject the traditional career ladder. Of his Gen Z staff, he said, “They’ve all said, ‘I don’t want it.’” He said he worries about the next generation of leadership because the millennial management class is so burned out, and his own ambition has been capped: “Why do i want to spend my life in meetings?”

Jane Swift, the former governor of Massachusetts who currently leads Education at Work, a nonprofit focused on the intersection of higher education and the workforce, told Fortune she sees the erosion of structured training programs and successor planning as a crisis in the making: “So we’ve done away with all these training programs, and it all happened when we stopped having these job ladders, right?” Referencing her own political affiliation with the Republican Party and its cliches about instinctively siding with bosses, she said this is a nonpartisan issue, bigger than the old talking point of “blaming the workers” because “people wanted to change jobs all the time.”

Swift described a chicken-or-the-egg problem where employers stopped being loyal to employees but employees also figured out that they needed to job-hop to advance in the careers. The end result is no “job ladders” like the ones she encountered when she entered the workforce in the 1980s, where you come into a training program with a clear progression afterwards. “We’re not training people as managers, so we have to go and figure that out,” but entry-level training is lacking, too. She said she feels “crazy” talking to some business leaders, because “AI is eating” entry-level jobs, but most of them want people with a few years of experience first. “Nobody trained millennials to be managers,” she said, “because we did away with these training programs.”

Economic experts are increasingly raising the possibility that the ladder to success may be taking on a different shape in the 2020s. Alex Bryson of University College London, who focuses on Gen Z’s rising sense of “despair,” told Fortune that he stumbled on a striking quote in his work, although he hasn’t seen research to back it up more substantively: “Moving on up the ladder, it feels as if, perhaps, for some of them, somebody’s removed some of the rungs.”

Nick Maggiulli, chief operating officer at Ritholtz Wealth Management and author of the New York Times best-seller The Wealth Ladder, told Fortune that “something weird’s going on” because the economy “wasn’t built to handle this many people with this much money.” He said that the wealth ladder isn’t meant to be climbed forever, and you often need to step back and ask yourself: “Do I need to keep climbing? Is this right for me?”

An empty feeling

Several millennial managers described hit-the-ceiling moments where more money or status brought little additional happiness, and often more problems to solve. A 37-year-old radiology director at a health system in Massachusetts said he’s gotten multiple pay increases and makes double what he did 10 years ago, but after a certain monetary threshold around $150,000, he stopped feeling the impact of a higher income. “I still feel just the same … probably just as happy or unhappy.” (He also noted that inflation and his four kids have eaten into his wallet a fair amount.)

One particular promotion, he recalled, “sort of felt empty. I remember the day my boss brought me [the financial terms] and nothing felt different. I just thought, ‘I have more things to solve now, more problems to solve.’”

Across healthcare, education, tech, and non-profit sectors, managers described relentless cycles of attrition, regime change, and ever-ratcheting expectations from above. Some of this is pandemic-related. The comms director who went to the ER over stress said that he believes there was a need to “take the foot off the pedal” when the pandemic ended, but he saw an older generation of managers realizing, “Oh, that’s how hard they can work.” He said return-to-office mandates were designed for the lowest-performing 5% of the workforce instead of the top 5%, and this is backwards.

A software engineer who works in big tech described emotional whiplash coming out of the pandemic. “It’s been rough the last couple years, honestly, with layoffs and a lot of uncertainty, and return to office.” She said she had “some really difficult conversations” about the end of remote work, on top of which she has to maintain a notoriously high standard at what she described as a ruthless company. “Doing great at other companies is not enough for here.”

She said a gallows humor has set in among her managerial peers, as they openly talk about what entrepreneurial project they’ll start when their own inevitable layoff arrives. Their Slack channel is called #buying-small-biz, she said, and it grew as an offshoot of one where they talked about how much they hated the end of remote work policies. “We all have to be thinking about what’s next, and we’re like, ‘Okay, cool, what business are we gonna start? When inevitably, you know …. Everybody knows what’s coming.” Commenting on the plight of herself and fellow managers, she added: “We’re definitely squeezed.”

Sanity days

Kaylan, a 38-year-old manager who leads a team at a major healthcare system that assists with escalated claims and benefit issues, similarly recounted how persistent understaffing carried potential medical risk. Calling herself a “high achiever,” she said that when most of her team juggles three projects on any given day “at one point I was probably working on 15 different projects in some way, shape, or form.”

She said she stopped and took stock of her workload when her own director was admitted to the hospital. Referring to this person as a mentor-type figure who has supported her growth and her career, she said her director didn’t elaborate on their hospital visit, but she suspects it was from stress. “That made me open my eyes and say, ‘You know, I don’t want to burn myself out to the point where I’m so stressed that I, too, end up in the hospital.’” She said that she took that cue to begin working with a therapist and began talking about different ways to implement boundaries for a healthier way of working.

Given their close relationship, she said it was a “wake-up call” for both of them, and they joke about mental health, somewhat darkly. She says she has a lot of PTO days unused and “I jokingly tell my director that those are my sanity days. And he laughs, because he’s like, ‘Man, I should probably take some sanity days with you.’” She clarified that they are really just “mental health days,” but both she and her director are better at giving good advice than taking it. She said she thinks the workforce in general has to start doing something differently “so we don’t all end up in the hospital because of stress.”

The myth and trap of the ‘cool boss’

There’s also a peculiar tension in the millennial management style: Determined not to replicate the rigid, hierarchical approach of their Gen X and boomer predecessors, millennials often strive to be the “cool boss”—open, transparent, and supportive. But sources told Fortune this approach can muddy the waters between leadership and friendship, engendering new vulnerabilities.

The radiology director described the start of his managerial career in a manner similar to what Rotz described: someone who seemed capable who was elevated without much training or guidance. In his mid-20s, he said, he was “thrust into a leadership position somewhat against my will.” He described a lack of standout mentors while saying that he has had some good mentorship on the clinician side of his practice, and one boss in particular was great “but also had immense responsibilities and so our 1:1s become more operational and less about my personal growth.” This boss sent him to a leadership program that lasted six months and still impacts his management style today: “It was great.” As an individual contributor, though, he said he underwent a “horrible onboarding program” and he worked to fix that when he got into management himself.

The radiology director said he struggled for years with managing people who started as his peers, trying to balance being “the cool leader” and navigating the situation as a new authority figure. “I let the lines blur because I was able to retain some of the people who were still my peers,” he said. “I did have to start setting boundaries because one of my buddies [and direct reports] would text me, saying, ‘Hey, I’m hungover.’”

A senior engineer at Netflix distinguished between millennials who try to be a “cool boss or a friend boss” and their more reserved Gen X counterparts: “My millennial manager is much more in tune with the human side … but the boundary has always been clear.” He framed it as an issue with an “intense” workload that can stretch far beyond a traditional 9-to-5 commitment. “If we work late one day, we come to work later the next day, or something like that. It can be intense, because you end up thinking about work when you’re outside, because there’s so much happening.”

Heather Hagen, director of employment services at a nonprofit in Colorado, spoke positively about the mentorship she’s received and about leading with empathy for her team. Hagen said she’s fascinated by the idea that millennials wear a “mask” as managers, that sometimes slips off when they get tough with their reports. She said she chooses to take on more responsibilities at work so her staff doesn’t get burned out, but acknowledges that she’s creating a culture of heightened expectation for her reports. “Maybe that’s kind of self-serving in the end, because I know that if I have a solid team who’s doing the work, I don’t have to deal with other people’s burnout, or other people leaving.” She described it as “I want this for you, but also, like, if everything goes bad, it would really be a problem for me.”

Hagen said she learned earlier in her career when it was “kind of like the veil lifted.” A former executive director told her “the reality of the finances” would always determine management priorities, even at a non-profit. She added that she thinks many millennial managers understand this, but they still seem to want to “package it up in a way that feels more caring and genuine to our teams.”

Are you a millennial who’s a manager, or do you have a millennial for a manager? Fortune would love to hear from you: get in touch at nick.lichtenberg@consultant.fortune.com



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Female libido pill gets expanded approval for menopause by FDA

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U.S. health officials have expanded approval of a much-debated drug aimed at boosting female libido, saying the once-a-day pill can now be taken by postmenopausal women up to 65 years old.

The announcement Monday from the Food and Drug Administration broadens the drug’s use to older women who have gone through menopause. The pill, Addyi, was first approved 10 years ago for premenopausal women who report emotional stress due to low sex drive.

Addyi, marketed by Sprout Pharmaceuticals, was initially expected to become a blockbuster drug, filling an important niche in women’s health. But the drug came with unpleasant side effects including dizziness and nausea, and it carries a safety warning about the dangers of combining it with alcohol.

The boxed warning cautions that drinking while consuming the pill can cause dangerously low blood pressure and fainting. If patients have several drinks, the label recommends waiting a few hours before taking the drug, or skipping one dose.

Sales of Addyi, which acts on brain chemicals that affect mood and appetite, fell short of Wall Street’s initial expectations. In 2019, the FDA approved a second drug for low female libido, an on-demand injection that acts on a different set of neurological chemicals.

Sprout CEO Cindy Eckert said in a statement the approval “reflects a decade of persistent work with the FDA to fundamentally change how women’s sexual health is understood and prioritized.” The company, based in Raleigh, North Carolina, announced the FDA update in a press release Monday.

The medical condition for a troublingly low sexual appetite, called hypoactive sexual desire disorder, has been recognized since the 1990s and is thought to affect a significant portion of American women, according to surveys. After the blockbuster success of Viagra for men in the 1990s, drugmakers began pouring money into research and potential therapies for sexual dysfunction in women.

But diagnosing the condition is complicated because of how many factors can affect libido, especially after menopause, when falling hormone levels trigger a number of biological changes and medical symptoms. Doctors are supposed to rule out a number of other issues, including relationship problems, medical conditions, depression and other mental disorders, before prescribing medication.

The diagnosis is not universally accepted, and some psychologists argue that low sex drive should not be considered a medical problem.

The FDA rejected Addyi twice prior to its 2015 approval, citing the drug’s modest effectiveness and worrisome side effects. The approval came after a lobbying campaign by the company and its supporters, Even the Score, which framed the lack of options for female libido as a women’s rights issue.

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This story has been updated to correct the age range of the FDA approval update. The agency approved the drug for postmenopausal women up to age 65, not older than 65.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.



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Gavin Newsom hires former CDC officials to work as public health consultants for state of California

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Two former senior officials from the Centers for Disease Control and Prevention, including one fired by the Trump administration, will join California as public health consultants, Gov. Gavin Newsom announced Monday.

California joined Washington and Oregon — two other states with Democratic governors — to launch an alliance in September to establish their own public health guidance and vaccine recommendations, as the Trump administration makes sweeping changes to vaccine and health policy.

Susan Monarez was fired as the CDC’s director and Dr. Debra Houry resigned as the agency’s chief medical officer and deputy director over disputes about changes at the agency. The two will work with California’s public health department to help build trust in “science-driven decision-making,” Newsom’s office said.

“By bringing on expert scientific leaders to partner in this launch,” Newsom said in a statement, “we’re strengthening collaboration and laying the groundwork for a modern public health infrastructure that will offer trust and stability in scientific data not just across California, but nationally and globally.”

California has increasingly positioned itself as a counterweight to federal health policy, and Newsom has amped up his criticisms of President Donald Trump and challenged the Republican’s policies in court. The governor’s final term ends in just over a year and he’s gearing up for a possible presidential run in 2028.

California state Sen. Tony Strickland, a Republican, said the new initiative is an example of Newsom prioritizing his national political ambitions over the state.

“California has serious problems, and we need serious solutions from a serious leader,” Strickland said in a statement.

The White House and U.S. Department of Health and Human Services did not respond to emails seeking comment on the hirings.

Trump and Health Secretary Robert F. Kennedy Jr. have repeated falsehoods about vaccines, and the administration has given health recommendations this year that experts say were not backed by science.

Trump in September urged pregnant women not to take Tylenol, saying it could pose a risk of autism to their babies, remarks medical experts said were irresponsible. The CDC website was changed last month to contradict the longtime scientific conclusion that vaccines do not cause autism. A federal vaccine advisory panel voted earlier this month to reverse decades-old guidance recommending that all U.S. babies get immunized against the liver infection hepatitis B on the day they’re born. The vaccine is credited with preventing thousands of illnesses.

Monarez, a former director of a federal biomedical research agency, was named acting director of the CDC in January. Trump later nominated her to to serve as director. She was confirmed by the Senate in July, making her the first nonphysician to serve in the role. But she was fired by the Trump administration in August after less than a month in the post.

Kennedy has said Monarez was fired after she told him she was untrustworthy. But Monarez said that was false in congressional testimony and that she was fired after refusing to endorse new vaccine recommendations that weren’t backed by science.

Houry, who spent more than a decade at the CDC, was among a handful of top officials at the agency who resigned around the time Monarez was fired. Houry said in August she was concerned about the rise of vaccine misinformation during the Trump administration, as well as planned budget cuts, reorganization and firings at the CDC.

She said she’s excited to join California’s new initiative.

“California will advance practical, scalable solutions that strengthen public health within the state and across states —showing how states can modernize data, share capacity, and work together more efficiently, while remaining focused on protecting people and communities,” Houry said in a statement.

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Associated Press writer Trân Nguyễn contributed.

This story was originally featured on Fortune.com



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Dealmakers are heading into the final weeks of 2025 on a $100 billion cliffhanger.

Paramount Skydance Corp.’s hostile bid to snatch Warner Bros. Discovery Inc. from under the nose of Netflix Inc. encapsulates the themes that have shaped a banner year for mergers and acquisitions: renewed desire for transformative tie-ups, massive checks from Wall Street, the flow of Middle East money and US President Donald Trump’s role as both disruptor and dealmaker.

Global transaction values have risen around 40% to about $4.5 trillion this year, data compiled by Bloomberg show, as companies chase ultra-ambitious combinations, emboldened by friendlier regulators. That’s the second-highest tally on record and includes the biggest haul of deals valued at $30 billion or more.

“There’s a sentiment in boardrooms and among CEOs that this is a potential multi-year window where it’s possible to dream big,” said Ben Wallace, co-head of Americas M&A at Goldman Sachs Group Inc. “We’re at the beginning of a rate-cutting cycle so there’s anticipation that there will be more liquidity.”

Beyond Netflix’s purchase of Warner Bros., this year’s blockbusters include Union Pacific Corp.’s acquisition of rival railroad operator Norfolk Southern Corp. for more than $80 billion including debt, the record leveraged buyout of video game maker Electronic Arts Inc., and Anglo American Plc’s takeover of Teck Resources Ltd. to reshape global mining. 

“When you look around and you see your peers doing these big deals and taking advantage of the tailwinds, you don’t want to be left out,” said Maggie Flores, partner at law firm Kirkland & Ellis LLP in New York. “The regulatory environment is in a position that is very conducive to dealmaking and people are taking advantage of it.”

The tally also shows a level of exuberance in certain pockets that some advisers and analysts worry is unsustainable. Global trade tensions are ongoing, and market observers are increasingly warning of a selloff in the white-hot equity markets that have underpinned the M&A resurgence.

Top executives at Goldman Sachs, JPMorgan Chase & Co. and Morgan Stanley have all flagged the risk of a correction in the months ahead, in part tied to concerns about an overheated artificial intelligence ecosystem, where huge amounts of investment have juiced technology stocks.

“These equity returns are really coming out of AI, and AI spend is not sustainable,” said Charlie Dupree, global chair of investment banking at JPMorgan. “If that pulls back, then you are going to see a broader market that isn’t really advancing.”

The AI buzz led to some the year’s standout transactions. Sam Altman’s OpenAI took in major investments from the likes of SoftBank Group Corp., Nvidia Corp. and Walt Disney Co., and a consortium led by BlackRock Inc.’s Global Infrastructure Partners agreed to pay $40 billion for Aligned Data Centers. In March, Google parent Alphabet Inc. framed its $32 billion acquisition of cybersecurity startup Wiz Inc. as a way to provide customers with new safeguards in the AI era.

“Everyone needs to be an AI banker now,” said Wally Cheng, head of global technology M&A at Morgan Stanley. “Just as software began eating the world 15years ago, AI is now eating software. You have to be conversant in AI and understand how it will affect every company.”

The technology sector more broadly has already notched a record year for deals, thanks to a series of big-ticket takeovers across public and private markets. The trend extended to the White House over the summer, when the US government took a roughly 10% stake in Intel Corp. in an unconventional move aimed at reinvigorating the company and boosting domestic chip manufacturing.

It was one of the clearest indications of Trump’s willingness to blur the lines between state and industry and insert himself into M&A situations during his second term, particularly in sectors deemed mission critical. His administration also acquired a stake in rare-earth producer MP Materials Corp. and Commerce Secretary Howard Lutnick has hinted at similar deals in the defense sector.

Trump has separately been positioning himself as kingmaker on high-profile transactions. The government secured a so-called golden share in United States Steel Corp. as a condition for approving its takeover by Japan’s Nippon Steel Corp., and the president recently signaled he’ll oppose any acquisition of Warner Bros. that doesn’t include new ownership of CNN.

“The Trump administration’s approach to merger regulation today is markedly different compared to the first time around,” said Brian Quinn, a professor at Boston College Law School. Quinn said he couldn’t think of a member of the Republican Party from 15 to 20 years ago who would now believe the US government “is involved in the business of picking winners.”

To be sure, bankers will be wondering if they could have achieved more in 2025 had it not been for the chaotic period earlier in the year, when deals were put on hold after Trump’s trade war hobbled markets. And in a sign that persistent economic challenges are still impacting some parts of M&A, the number of deals being announced globally remains flat.

Many small and mid-cap companies have lagged the broader stock market and are opting to pursue their own strategic plans instead of weighing inorganic options, according to Jake Henry, global co-leader of the M&A practice at consultancy McKinsey & Co.

“They’re thinking ‘I’m better off just operating my business and getting there.’ It has to be an explosive offer for them to come to the table,” he said.

Meanwhile, private equity firms, whose buying and selling is a key barometer for M&A, are still having a harder time offloading certain assets because of valuation gaps with buyers. This has had a knock-on effect on their ability to raise funds and spend on new acquisitions. But bankers are starting to see a recovery here too as interest rates come down and bring more potential acquirers to the table.

“What’s motivating sponsors more than anything is their need to return cash to investors,” said Saba Nazar, chair of global financial sponsors at Bank of America Corp. “We have been in bake-off frenzy for the last couple of months.”

Road to Record

Dealmakers began the year whispering of M&A records under Trump’s pro-business administration. While they will just miss out on the milestone in 2025, there is a strong sense on Wall Street that those early bumps only delayed the inevitable. 

Brian Link, co-head of North America M&A at Citigroup Inc., said that after ‘Liberation Day’ in April, he expected to spend more time figuring out the impact of tariffs on different business and how to adjust around that. 

“That has not been the case,” he said. “Unless fear creeps back into the market, there doesn’t seem to be anything in the near term that’s going to change the dynamic here.”



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