EXPERTISE
Dr. Devika Fiorillo, PhD, is a clinical psychologist providing evaluation and psychotherapy services for adults and adolescents. Trained at leading academic medical centers, with advanced training in addressing trauma, anxiety, and related disorders, she has the experience and expertise to help you move forward.
SPECIALTY PRACTICE
Her practice is focused on anxiety, obsessive-compulsive disorder (OCD), depression, and trauma-related disorders, consistent with her training and experience. This specialized approach includes staying current with treatment and research developments, providing cutting edge evidence-based therapy and maintaining a high quality of care.
THERAPEUTIC APPROACH
Dr. Fiorillo conducts her practice within a cognitive and behavioral framework in which thoughts, emotions, and behaviors are conceptualized as being linked. She provides effective change and acceptance based treatments to intervene in these areas, tailored for each individual.
ANXIETY AND RELATED CONCERNS
Anxiety can be a normal reaction to stress. However, anxiety disorders differ from normal anxiety. Anxiety disorders typically consist of excessive fear and nervousness, often resulting in avoidance and other behavioral disturbances. Different aspects of life such as performance at work or school and social relationships can be negatively impacted. A number of specific problems fall within the umbrella of anxiety and related disorders including:
Agoraphobia (fear of places where you may panic or feel trapped, helpless, or embarrassed)
Generalized Anxiety Disorder (excessive, persistent, and uncontrollable worry about various aspects of life, often including heightened and chronic nervousness)
Obsessive-Compulsive Disorder (OCD) (persistent, unwanted thoughts, obsessions, and repetitive behaviors or mental acts (compulsions) that someone feels compelled to perform to achieve a perceived reduction in anxiety or distress)
Panic Disorder (out of the blue panic attacks characterized by overwhelming physical and psychological distress and fear of having panic attacks)
Social Anxiety Disorder (fear or being scrutinized or judged by others)
Specific Phobia (fear of specific object, situation, or activity such as closed-in spaces, driving, flying or air travel, heights)
If you are having problems with anxiety, we will begin to determine the nature of the problem in the initial evaluation. Depending on the problem, Cognitive Behavioral Therapy (CBT), Exposure Therapy, or Acceptance and Commitment Therapy (ACT) have been studied and shown to be effective. Treatments will be explained to you in detail to help you take an active role in making an informed choice.
Sometimes anxiety is secondary or related to other problems including depression, chronic pain, and sleep disorders. Cognitive and behavioral therapies have been shown to be effective in treating one or more of these problem areas and can be discussed and treated as well.
DEPRESSION
Depression is the most common mental health problem. One in four individuals experience significant depressive symptoms over the course of a lifetime. There is no single reason that fully explains why one might get depressed. Biological makeup, upbringing, reaction to life events and stressor, and relational difficulties are some issues that can contribute to depression. There are several symptoms that makeup depression, although not everyone experiences the exact same set of symptoms. Individuals who are depressed tend to tend to have persistent negative mood, and negative thoughts about oneself, the future, and the world. Feelings of sadness, hopelessness, emptiness, worthlessness, guilt, and irritability are some of the feelings that are associated with depression. Changes in physical sensations and other changes can also be part of depression including fatigue and tiredness, sleeping more or less, eating more or less, and difficulties concentrating or perhaps even with memory. Because of depressed mood and other difficulties, those with depression typically see change in behaviors as well. In particular, individuals with depression do less over time and engage less in activities that may otherwise have been an important part of life. Depression can get to a point where one may not be motivated to do things at home, or go to work or be fully engaged at work. Isolation from other activities and family and friends are other types of changes in behaviors that can occur with being depressed. At times, depression can also lead to suicidal thoughts or ideation. In addition to symptoms, the length of time since the start of depression also vary with individuals. In order to be properly diagnosed, one needs to see a mental health professional. Generally speaking, depressive episodes can be diagnosed once they’ve lasted for at least two weeks. Sometimes they occur in phases and can come and go, but in other instances, depression may be more chronic lasting for months or even years.
Although depression can be quite serious and difficult to cope with, and you may find it difficult to reach out for help if you’re feeling depressed, there are effective treatments particularly within the cognitive and behavioral realm, which Dr. Fiorillo has significant experience with, to help you overcome depression.
TRAUMA AND PTSD
Although Post-traumatic Stress Disorder (PTSD) is known by many in reference to symptoms faced by combat veterans, it more generally refers to a set of symptoms experienced by those who have been through various kinds of traumatic events. These include experiences such as rape, abuse, assault, natural disasters, motor vehicle accidents, in addition to distressing military experiences and other traumatic events. Symptoms of PTSD generally fall under four main categories including intrusion, avoidance, negative changes in cognitions (thoughts) and mood, and difficulties with arousal and reactivity (eg. heightened startle response).
Complex PTSD is another diagnosis discussed in relation to trauma, particularly prolonged and repeated trauma. For individuals with this kind of experience, posttraumatic symptoms may include additional problems in different areas including emotion dysregulation, dissociation, self-perception, and relationships with others.
In addition to PTSD and Complex PTSD, there are other problems that can be associated with trauma. These can include depression and anxiety, among others related disorders.
Perhaps you have already been made aware of what you are experiencing or maybe you are just starting to think about these issues. Either way, an initial visit will be helpful to understand how trauma may have impacted you. Based on your particular circumstances, there are a number of effective treatments available to you. Prolonged Exposure Therapy (PE) and Cognitive Processing Therapy (CPT) are treatments that have been found to be effective in the treatment of PTSD. If you are dealing with more complex trauma symptoms, Dialectical Behavior Therapy (DBT) is an approach which focuses on learning skills that could be helpful. For depression or anxiety related to trauma, certain additional cognitive and behavioral approaches that are helpful for treating these problems can be further discussed with you.