At the school reunion in Girls, one former classmate recounted having seen Effie:
Last summer, Marinka says, by accident, on the street, "I didn't recognize her." She says that you, Effie, now weigh about 190 pounds, huge, a barrel, because they gave you insulin when you needed lithium - "But lithium also adds weight," one of the boys, now a chemical engineer, says...
Was Effie given insulin shock therapy? If so, when was this story likely placed, and why did she receive that? This particular treatment, which was largely used for schizophrenia, fell out of favor in the 1960s (probably due to the introduction of better psychiatric medications like lithium, antipsychotics, and antidepressants).
I recall reading (I don't recall where) that Soviet psychiatrists tended to be pretty far behind the times, evidently only being aware of behavior modification and antipsychotics as a treatment method even when numerous other methods were available. If I'm correct in my memory, would this have played a role?