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Now that I'd had this for a while, and feel confident that I know what it is, and it seems to be stable and not progressing to something worse, I think my biggest fear is that this will affect my interviews for permanent jobs. In my field, they fly you in for two or three days of interviews with dinners and giving an hour-long seminar and such. I tend to walk into things, stagger sometimes, generally look like I've been drinking, and then I zone out occasionally in social situations from the derealization stuff. It seems like all of those things are not ideal for making an excellent impression! It takes an awful lot of energy and concentration to fake it, but I guess I'm just going to have to try the best I can. I worry that if I explain the PMA, they're going to wonder what else is wrong with me, and that might hurt my chances of being hired (yeah, I know its illegal, but it happens anyway).