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Your other options are (a) suicide, or (b) becoming a nihilist, which is like suicide but with more thinking.
The middle managers are perpetually faced with the prospect that if they choose A, they have to give up B, which is of equal value (within reasonable error bounds). This is a very real part of their lives.
They remind us about opportunity cost, which turns out to be one more thing that they can't hope to calculate. At the end of the day, the average effect of their decision making is net zero.
And I think part of what cripples decision making is in fact the fear of opportunity cost, because every decision requires considering an infinite number of alternatives.
[]unless we reverse aging soon