When Being ‘Real’ Is ‘More Valuable Than Wearing a Mask’

Macduff has written in journals since she was a young girl; it’s one of the ways she’s steadied herself during turbulent times. At 14, Macduff began dating a boy who attended a nearby school. They dated for nearly five years, during which Macduff felt controlled and invalidated by him. “I started to think that I was the problem, and I was doing things wrong,” she said.

During that relationship, Macduff began purging after meals—an act she now recognizes was an effort to gain control over some part of her life. She hid her disordered eating from her mom for almost two years, until one day Teri opened the bathroom door while Ella was throwing up.

“It’s a real struggle when your daughter is unhappy or incredibly anxious, and you don’t know what to do, so I got her help and my own help,” Teri said.

Later, during winter break of Macduff’s freshman year in college, a night out in her home state of Massachusetts left Ella with lasting trauma. She was at a bar with her then-boyfriend and some friends when he went to the restroom, and she left her perch to say hello to some acquaintances she recognized across the room. “That’s the last thing I remember of the evening,” said Macduff.

When her then-boyfriend returned from the bathroom, Macduff was holding a new drink and couldn’t tell him where it came from. She started to feel sick and asked him to call an Uber. Macduff began throwing up in the car, prompting the driver to order them to get out. Teri picked them up from the side of the road, then drove Ella to a hospital as she drifted in and out of consciousness.

At the hospital, a doctor diagnosed her with serotonin syndrome—a result of having too many drugs in her system. Although she was released without a drug test, Macduff believes that the only explanation for what happened that night is that someone drugged her drink. (Last summer, Macduff testified at the Massachusetts State House about her experience as part of an ongoing effort to pass a bill requiring drug tests be given to patients on request.)

“To this day, I have a lot of anxiety when I go out,” said Macduff. “It’s something I know is going to stick with me forever.”

As Macduff went through therapy, she learned ways to manage her anxiety and how to examine her experiences honestly. After one discussion with her mom about their “road maps of personal growth,” as she described it, the pair decided to start Chasing Red Flags, a mission-oriented wellness brand dedicated to raising awareness about mental health and encouraging young people to face their realities directly.

In their podcast, they interview psychiatrists, therapists and advocates on topics ranging from substance use to eating disorders. “Let’s Get Real,” the journal, asks users to reflect on their inner life with prompts like “What’s your go-to strategy for managing overwhelming feelings?” or “What is one activity that embodies the word ‘relaxation’ for you?” The journal, which was reviewed by a team of mental health professionals, also offers tips on building self-confidence, establishing healthy boundaries and trusting your instincts.

The journal “expertly balances vulnerability with empowerment,” said psychotherapist Nadine Macaluso. “It offers a framework for meaningful growth without falling into self-help cliches.”

Today, Macduff, who lives in Needham, Mass., is working on building a community around “Let’s Get Real.” She’s held events where people use the journal as a jumping-off point for conversations and connections, and she hopes to bring it to high schools, universities and companies.

“My goal is to make being real more valuable than wearing a mask,” she said.