>I think that what Freud is talking about is the let-down after achieving a particularly difficult goal--not about people who are successful relative to their peers after a long career in which they exert effort that is within the range of normal for people of the same social class.

I was thinking of it in terms of stress. Everything you cited, from a woman trying to get married and an academic getting a bigger job, these are major life events. We know all major life events, good and bad, are stressful and the more stressful events we experience within a year, the more likely we are to end up sick. The human body can only deal with so much stress before it begins to break down.