Mental Health in Charleston and Mt. Pleasant, SC

Reviewed by Ashley Harwyn, PA-C, ABAAHP  |  A4M Board Certified  |  Updated October 4, 2026

We are the medical side of your mental health care, not a replacement for therapy or psychiatry. Here is what we check, how gene testing really performs, and where to get help today.

If you are in crisis or thinking about suicide, please do not wait for an appointment. Call or text 988 to reach the 988 Suicide & Crisis Lifeline, or chat at chat.988lifeline.org. It is free, confidential, and available 24 hours a day, every day of the year.[1] If you or someone near you is in immediate danger, call 911.

• Solcara is not a psychiatry or therapy practice. We work alongside your therapist or psychiatrist, check for medical contributors, and help manage medications and supplements.
• The USPSTF recommends depression screening for all adults and anxiety screening for adults 64 and younger, using short questionnaires such as the PHQ and GAD-7. A positive screen calls for a fuller assessment, not a label.[2][3]
• Depression treatment typically means psychotherapy, medication, or both, and antidepressants usually take 4 to 8 weeks to work.[4]
• Gene tests such as GeneSight can flag some gene-drug pairs that change drug levels and dosing, for example CYP2C19 with citalopram.[6][7]
• They cannot tell you which antidepressant will work. In the large GUIDED trial, gene-guided care did not significantly improve the main symptom score, though response and remission rates were higher.[5]
• Do not start, stop, or change a psychiatric medication on your own, whether because of a test result or a supplement. Talk with your prescriber first.[4]

Where Solcara fits in your mental health care

Mood and anxiety symptoms happen in a body, and the body can be part of the cause. The National Institute of Mental Health (NIMH) notes that certain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression, and that a provider can rule these out with a physical exam, an interview, and lab tests.[4] That medical side is where we spend most of our effort. We go through your history, your current prescriptions and supplements, your sleep, and your hormones, then order labs that answer a real question, often starting with thyroid testing or a full lab panel.

Hormonal transitions can matter too. NIMH describes perimenopausal depression, which affects some women during the transition to menopause, and perinatal depression during pregnancy or after childbirth.[4] When hormones may be part of your picture, we can look at that through our hormone care, as one piece of your treatment and never as a substitute for mental health care.

What we do not do is stand in for a psychiatrist or therapist. We do not provide psychotherapy, and severe or complex conditions belong with psychiatry. If you already have a therapist or psychiatrist, we coordinate with them, with your permission, so your medications and labs are not managed in separate silos. If you do not have one and you need one, we will tell you so plainly.

We also want the room itself to feel safe. Patients come to us from very different backgrounds and beliefs, and some have had rough experiences with the health system. We aim to offer a culturally respectful space where you can say what is really going on without being rushed. Visits are with Ashley Harwyn, PA-C, who is board certified in anti-aging and functional medicine (A4M) and holds the ABAAHP credential, either at our office at 496 Bramson Ct in Mount Pleasant or at The Longevity Club, 163 Rutledge Ave, in downtown Charleston.

How depression and anxiety are screened and treated

Screening takes a few minutes. The US Preventive Services Task Force (USPSTF) recommends screening all adults for depression, including pregnant and postpartum people and older adults, as a grade B recommendation issued in 2023.[2] It also recommends anxiety screening for adults 64 and younger, and found the evidence too limited to weigh benefits and harms for adults 65 and older.[3] Common tools include the Patient Health Questionnaire (PHQ) for depression and the GAD-2 or GAD-7 for generalized anxiety.[2][3]

A questionnaire is a flag, not a diagnosis. The Task Force says every positive depression screen should lead to further assessment to confirm the diagnosis, gauge severity, and look for other psychological problems.[2] For anxiety, it says positive screens should be confirmed by a diagnostic assessment, with evidence-based care offered or arranged.[3] Anxiety is common: the Task Force reports a lifetime prevalence of anxiety disorders in adults of 40.4% for women and 26.4% for men.[3]

One nuance surprises people. The Task Force found too little evidence to judge routine suicide-risk screening of all adults, and it still asks clinicians to know the warning signs, listen to concerns, and make sure people who need help get it.[2] In practice, that means we ask when there is concern, and you can always bring it up first. Outside our office hours, 988 is there.

Treatment for depression typically involves psychotherapy, medication, or both, according to NIMH, and evidence-based talk therapies include cognitive behavioral therapy and interpersonal therapy.[4] Antidepressants take time, usually 4 to 8 weeks, and sleep, appetite, and concentration often improve before mood lifts, so giving a medication a fair chance matters before deciding it is wrong for you.[4] NIMH also advises talking with a health care provider before starting or stopping any medication, and notes that people under 25 may have an increase in suicidal thoughts or behavior on antidepressants, especially in the first weeks or after a dose change.[4]

Want the medical side looked at while you keep your therapist? Call 843-981-0870 and we will go over your medications, supplements, and labs, and explain plainly what a gene test could add. If you are in crisis right now, call or text 988 instead.

What a gene test like GeneSight can and cannot tell you

We offer GeneSight, a commercial pharmacogenomic test. Pharmacogenomic tests look at genes that affect how your body handles medicines, and for antidepressants the best-studied are liver enzyme genes such as CYP2D6, CYP2C19, and CYP2B6.[6] Variants in these genes can change how much of a drug ends up in your blood, which may affect dosing, side effects, and how well it works.[6] The FDA lists several of these pairs. For example, people who are CYP2C19 poor metabolizers have higher citalopram levels and a higher risk of a heart-rhythm side effect called QT prolongation, so their maximum recommended dose is 20 mg.[7]

That is useful information for a prescriber. It is also much narrower than the advertising around these tests suggests. Here is how the common questions sort out against the evidence: