time for a change

The theme in my life right now seems to be that I suck at life. No really. I am so self absorbed and have too much going on all the time. I've neglected relationships with the most important people while trying to keep up with too many other people. When my kids are talking to me these days I catch myself drifting in & out of the conversation overwhelmed by all my brain & heart is dealing with right now.
WARNING! Complaint time:::: I am so emotionally drained and completely exhausted. I have a headache I can't seem to shake that in moments of silence, like right now, I want to shove my fist thru my forehead to make it stop. I can't seem to get any rest. I've had intense dreams that don't make any sense but keep me up at night. That stupid rib keeps going out and I'm about to lose my mind over it. My stress level is way up as stuff keeps coming at me and my tmj pain is about a 6 right now as I catch myself clenching my teeth once again. Something's gotta give!:::: Now back to normal programming.
So what do you do when you realize it's time for a change? How do you cut back on things? How do you MAKE more time when there's none there? I am re-evaluating how I spend my time. For me it's not hours in a day, it's events in a week. I guess I gotta learn how to say "No." I need to take a good look at my priorities. I just can't do everything I want to do. I can't be there for everyone all the time. I can't do it all.. as much as I want to.
I know this is going to let some people down and that is really hard for me, but I've already let the people down who matter most and that feels even worse. God is definitely leading me on this one. It's unbelievable how in my face it all is. There comes a point where you have to take action. I get that things aren't well balanced so what am I going to do to fix it?