My thoughts from working in the mental health field is that Gracie is not ready yet emotionally for a return. Its not about how anxious she looks on the ice or how she performed, its how she reacted to the score she got. She was not resilient enough yet to handle a negative performance and score. That's something she's going to need if she wants to continue to compete, even if her general performance improves, she needs to have the coping ability to handle setbacks and disappointment. Because from my understanding, that is what contributed significantly to a lot of her worsening mental health symptoms - difficulty handling and interpreting setbacks and the ability to not let it influence her next skate.
In many ways, her ability to handle the Rostlecom skate is not that different than emotional wellness needed to handle "4th place at Worlds" disappointment. She does not yet have the skills or emotional resilience for competition yet. Even if she had performed exceptionally, she would just be delaying the inevitable if she's not able to handle setbacks. Look at how Kaori and Zhenya were able to bounce back, at some point Gracie would have a similar skate and she needs to be emotionally ready for that.
Honestly, my sense is that Gracie isn't skating for herself but rather because of some expectation she has (or family or perceived social pressure) for herself. To me, it doesn't look like she put in the necessary hours of training needed for someone who really "wants it" and is competing because of her love of skating. If she really wanted to come back in a healthy way, she would need to start by getting off social media completely and continuing to surround herself with an appropriate mental health team (e.g., therapy at least 1-2 times per week, dietician who can help her adhere to a healthy eating plan, and a sports psychologist/performance coach).
But more importantly, she'd need to really decide that she was doing this for HERSELF. Not for fans,or family or because she has talent or because she thinks she's supposed to or because she's trying to chase what she almost had. A comeback for Gracie has to start with a true love for skating. She enjoys the experience of skating, values the work that goes into it, and her only reason to compete should be because she wants to prove to HERSELF what she is capable of. If that's her mentality, that she goes into the gym to train everyday to show herself what she's capable of and what potential she has, then she can never fail. Because she can't be disappointed in herself if she's doing it only for her and knows she put in the work. Yes, she can be disappointed in a competition or a skate or the results, but if she knows she put in 110% to training and did her best at the moment then she didn't let anyone down. Each competition should be about enjoying that moment and having a chance to show herself the hard work she has put in. Outcome shouldn't matter (for her to get back to a healthy mentality), but what should matter is every day of practice at the rink, every training session at the gym, and every healthy decision she makes for her mind/body in between. But honestly, I don't get the sense that she loves it that much to prover to herself what she is capable of. Instead, I think she doesn't know who she is without skating and there is so much more to her and so much more to life if she is ready to move on.