Warning: This article contains SPOILERS for The Boys season 4, episode 6, “Dirty Business.”

MM passes out during a mission in The Boys season 4, episode 6 — and although it initially seems like he’s having a heart attack, a later scene reveals that it’s a panic attack. MM sends Hughie to infiltrate Tek Knight’s Federalist Society party in “Dirty Business,” hoping to learn more about Sister Sage and Homelander’s plans. Although Hughie is disguised as Web Weaver, it soon becomes clear that he needs to be extracted. Starlight, Kimiko, and MM show up to save him, but they’re confronted by Sage before they can reach him.

Sage brings up aspects of MM’s personal life, and their confrontation almost turns deadly when he shoots her. MM hits Sage in the head, but he doesn’t realize she can survive this. Believing he’s killed her, he clutches at his chest and passes out. Things seem dire, but fortunately, A-Train arrives to transport him to the hospital. There, The Boys season 4, episode 6 reveals that a panic attack is the reason MM passed out at Tek Knight’s mansion. And although it seems like a response to MM’s run-in with Sage, the reason for his reaction likely goes beyond that.

Taking Over The Boys From Butcher Has Made MM More Stressed

The Boys Season 4 Alludes To It Repeatedly

MM’s panic attack might be a direct result of his confrontation with Sister Sage, but it isn’t the first time The Boys season 4 alludes to his anxiety. The Boys’ leader attempts to calm himself with meditation and self-help books throughout the latest outing. He also reveals he’s breaking out in hives in The Boys season 4, episode 5, suggesting his interventions aren’t working. MM’s stress seems to be increasing as season 4 continues, and there’s an obvious reason for it. MM replacing Butcher as the leader of The Boys is taking a toll on his mental health.

Leading the charge against Homelander and Vought is a gargantuan task on its own, so it’s no wonder MM’s anxiety is showing itself more in season 4. Of course, it doesn’t help that he’s facing pressure from multiple sides. The CIA isn’t happy with him, and the people he answers to aren’t shy about letting him know. The members of his team are also struggling, and keeping them safe is a priority — but it’s a tough one to balance with the need to take down Vought. And Butcher isn’t making MM’s job any easier, often refusing to listen to his orders.

MM’s Panic Attack Sets Up Butcher Becoming The Boys’ Leader Again

The Boys Suggests He’s The Best Person For The Job

MM’s panic attack in The Boys season 4, episode 6 isn’t that surprising considering the stress he’s under this season. It indicates that he’s reaching a boiling point as The Boys’ leader, and it’s unclear if he can continue operating this way. MM’s attempts to keep his stress under control don’t seem to be working, and he’ll eventually need to prioritize his health and well-being. Passing out on the job could also be seen as a liability, as it puts his life in danger and threatens to compromise the mission.

Needless to say, The Boys may be setting Butcher up to become the team’s leader again through MM’s panic attack in episode 6. Episode 5 already alludes to him being the best person for the job, with Kessler suggesting he’s the only one who can do it. Although Butcher comes off as unfeeling and extreme, these qualities are useful when taking on Homelander. His willingness to shirk the rules and make difficult calls is a strength against Vought. MM is probably the only other person capable of leading the team, but his panic attack may serve as a wake-up call for him.

MM Is Struggling To Balance His Work & Home Life In Season 4

His Family Gives Him More To Worry About

Stress over the job is definitely getting to MM in The Boys season 4, but his home life is also contributing to his increased anxiety. MM’s ex-wife and daughter show up sporadically throughout The Boys, and season 4 makes a point of digging into MM’s relationship with them. The latest outing reveals that he’s struggling to balance his work and home life, with the former often overshadowing the latter. Monique urges him to be there for their daughter more, especially after Todd’s demise, but running a team like The Boys doesn’t leave much time for personal relationships.

Episode 6 may push MM to reevaluate his priorities, especially if he believed his life was truly in danger. It’s not just the fact that his panic attack nearly jeopardizes the mission, though he’ll likely consider this a reason to step down. But if MM continues pushing his mental and physical health to the limit, it could have serious consequences. It may even impact his ability to be there for his daughter, which is something he’ll want to avoid. This wake-up call might give him clarity, finally convincing him to choose his family over The Boys.

MM Was Already Living With OCD When The Boys Started

There’s a greater focus on MM’s mental health in The Boys season 4, but his anxiety and obsessive compulsive disorder aren’t new. MM was already living with OCD when The Boys began, and his condition has been referenced and alluded to during the earlier seasons of the show. One poignant scene from The Boys season 3 really drives it home, as MM tells Starlight that his OCD started after Soldier Boy attacked his family. He reveals that he has to check the burners three times per night — and if he doesn’t, he believes the Supe will return.

The Boys’ depiction of OCD and anxiety is well done, and it has received a lot of praise over the course of the show. The Boys season 4 continues to do an impressive job of portraying MM’s condition and how it’s affected by what happens around him. It also unpacks his trauma and how it manifests in adulthood. Hopefully, The Boys season 4, episode 6 will push MM to seek out help — or at least remove some of the external pressure that’s increasing his stress. A-Train may not be there to help next time, so it’s crucial that he addresses his panic attack.