I decided my list of responsibilities had become too much for me to handle if the organization was going to continue to grow. I went to my boss and explained my situation, and although he had been satisfied with my performance, he was concerned that we weren't progressing at a fast enough pace and were missing the big picture. After much discussion, it was decided that we would parcel out the job I had been doing, and I would take a step back and manage a much smaller group.
The move was a hybrid of demotion and structure change, but I was self-conscious because my pride and reputation were at stake; it would be difficult for me to face my fellow employees knowing that I was moving down, not up.
In the end, though, it worked out. My stress level became manageable, I was back doing the work that I most enjoyed, and I was able to spend more time with my family. The company ended up hiring three managers to do the job that I had been doing by myself. Nobody ever said anything to me about the move, but for a while I would sit in meetings and in the back of my mind wonder what people were thinking about me.
What did I learn? Don't bite off more than you can chew, and opportunities that seem too good to pass up might end up driving you mad.