When we see Riley in Chapter 5, she's feeling okay. She is often okay. A song recently inspired this series of sketches where she's not okay.
Her "gremlins" are a constant source of stress and exhaustion. It feels like she is constantly fighting against her own mind and body, and it's a fight she doesn't always win. It's a fight that may be, ultimately, unwinnable.
But one reason I think I love this character so much is that it isn't about winning. It's about never giving up the fight.