As a couple, you’re ecstatic. One of you slogged through exam preparation, endless essays, formidable forms and now there’s finally an acceptance letter in the mail. But what should you anticipate when one of you is starting graduate school? Beginning work on a new degree can have a significant impact on your marriage.

Obviously, the seismic impact of graduate school depends somewhat on the nature of your spouse’s program, and some factors are unique to different situations. However, here are six areas to pay close attention to while your husband or wife is earning their advanced degree.

Time Management and Dealing With Stress

Time with your spouse will become a precious commodity no matter what kind of school he or she is attending. After spending much of the day in lecture, your spouse will be expected to hit the books, project meetings, or the lab. Those nights catching up luxuriously on five episodes of "Modern Family" will be the first to go. To make matters more frustrating, your spouse might have chunks of free time during the day when you’re tied up at work.

It’s important not to put pressure on your spouse, who has plenty to get stressed out about, to give you the kind of couple time you had before. It simply isn’t going to happen. Rather, at the beginning of the term, schedule a date night that happens at the same time (ideally) each week. Date night might consist of macaroni and cheese, bad Merlot and venting about your day together; or it might be a romantic jaunt on the town. What matters is that you’ve asserted the importance of marriage-time by putting it on your spouse’s schedule along with torts lecture.

Relationship Drainers

Medical and law school probably have the worst reputations for monopolizing spouses, but don’t underestimate PhD and MBA programs. MBAs are under pressure to show up at a staggering number of happy hours and social events because they have a short two years to establish the networks that will support their entire careers. They also spend a lot of time in massively inefficient project meetings with classmates of varying levels of intelligence, commitment and sobriety. PhD (and even some master’s) theses have a tendency to grow into massive, untamable monsters. Lab experiments fail and require redos that find hapless future biologists and chemists pulling all-nighters to avoid getting crucified by their PIs (principal investigators, or the people who take credit for your spouse’s work).

You might feel less able to relate to your grad-student spouse. Some students come home and want to talk about anything but ion channels or criminal law, but others simply will not shut up about the dead fetus in anatomy lab, or the inner workings of Ford Motor Company. Be patient, and see it as an opportunity to gauge the professional interests of your spouse. Some day, bewildered at a career crossroads, you’ll be able to remind your spouse, "You loved learning about X in grad school, remember?" Remember, too, that your career and activities are important, and make an effort to bring stories and comments on the table to keep things on equal footing.

Dealing with Finances

Finances are a major concern for a couple pursuing higher education in any way. (This topic is an article in itself, and for a start I would recommend the book "Debt Free U" by Zac Bissonnette). Unless your wife or husband has scored a full-ride scholarship, things are probably going to be tight. Budget, budget, budget. Do not take out more loans than are necessary. The exception to this is, let’s say you can get a crazy-low interest rate on a school loan and lock the interest rate in—well, you’ve just outsmarted the bank. Many couples have used this strategy to avoid higher interest rates on car and home loans. You use the extra cash from the loan to pay for things you need (emphasis on need). I am only talking about federal loans here, by the way. If you have time after work, you can be a huge help to your spouse (and a great money-saver) by packing lunches for your dearest to avoid expensive trips to the campus sandwich shop.

Sleep Deprivation and Sex

Be prepared for rather impressive levels of fatigue in your spouse. All-nighters, 30-hour hospital shifts, and the like take a massive toll. Don’t take it personally if she walks in the room still wearing scrubs and falls asleep drooling on your arm 30 seconds later, or gets weirdly possessive about sleep. On the flip side, if your spouse rising at 3 a.m. to go to the hospital is messing up your sleep and work performance, it’s not illegal to sleep separately a couple of nights a week. Rest is important for immunity, happiness, and your mutual sex life.

Speaking of sex, this one tends to go out the window for non-proactive couples. Do something about it and bend to her schedule. If you notice your spouse is most grumpy in the morning before leaving for class, suggest intimate activities in the evening. Surprise romantic gestures are hit or miss for someone with a midterm in two days, so don’t expect your wife to be swept off her feet and toss her study papers aside. Better to plan your time together and schedule it at strategic times (after-exam date, romantic reward for getting through 100 practice questions, etc.). You can almost create a Pavlovian response; your spouse will look forward to these moments and associate her academic accomplishments with affection immediately to follow. A win-win situation.

Dealing with New "Friends"

Finally, the power of the social bubble of graduate school absolutely cannot be overstated. You're talking about a group of young or youngish people who are all smart, excited about the same thing, and who spend many hours each week together. It's a perfect setting for lust. As the spouse, you should be aware that it is very, very, very common for long-term relationships to break up when the graduate student gets carried away and makes "study dates" into something more. Once, I begged a friend whose longtime girlfriend was off to medical school to propose to her. He decided to wait a few months, and before he knew what was happening, he was single.

Tips for the Long Haul

Following the guidelines above is a start to preserving the value of your marriage. You should also make an effort to enter the social bubble. Attending the school Christmas party or after-exam keg party is like marking your territory. The more the other students get to know you as a person, the less 'available' your attractive spouse will seem. They need to see you as a happy couple, as frequently as possible.

If possible, you can also go to the campus and visit your spouse between lectures. That way, you get to spend quality time together in the daytime and in her environment, as opposed to only at night when she’s an exhausted heap. Face it, your shabby little apartment pales in comparison to the rich social life and intellectual stimulation of graduate school, and it’s important to integrate yourself in every part of your spouse’s life so that she doesn’t unconsciously associate you with dirty dishes and being exhausted.

Knowing the worst-case scenario can prepare you for making a better situation for your spouse's time in graduate school. The years can be fun and full of discovery and accomplishment. Be there for awards ceremonies, provide hugs when things don't go well, and make efforts to understand the dynamics and pressures in the graduate program. At the same time, ensure that you have time together when you've got each other's full attention (and are both fully awake). That balance will keep your marriage healthy and happy.

Monya De, MD MPH is a physician in Los Angeles. She has contributed to the Economist, the Los Angeles Times, The East Bay Express, the New Physician, and more. You can follow her on Twitter at @medjournalist.