How do you manage it all?

How do you all manage life and work stress while still getting all the things done?

I’ve been in accounting/finance for 15+ years, all with startups or PE-backed firms. I’m in my first year as a VP of Finance, and I’m married w/o kids. I’m stressed out 100% of the time and struggle to breathe sometimes with what I feel are the pressures and demands of work and life. I couldn’t imagine trying to raise children at the same time. I regularly work 12+ hour days and by the time I get home, I have zero energy to do anything aside from eat a quick bite of food and chat with my spouse for a bit before I need to sleep.

So…how do you all manage it? How do you raise a family and are successful and productive with work without the stress killing you?