Muscular dystrophy (MD) refers to a group of genetic disorders in which a person’s muscles gradually weaken and atrophy (waste away) over time. While muscle-related symptoms are central to MD, individuals with this condition often face a higher risk of additional health complications. These are often called “comorbidities,” meaning they occur alongside the main disease.

Some of these comorbidities affect mental health, cognitive function (thinking and memory), and other systems of the body. Managing these challenges can be complex, but early detection and treatment are critical for improving overall well-being. Addressing these health concerns early may help people with MD maintain better long-term physical and mental health and potentially extend life expectancy.

This article will discuss eight conditions that commonly occur in people with muscular dystrophy.

1. Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a common comorbidity in individuals with certain types of muscular dystrophy, particularly Duchenne muscular dystrophy (DMD). ADHD symptoms include:

• Inattention (difficulty staying focused on tasks)
• Impulsivity (acting quickly without thinking about the consequences)
• Hyperactivity (excessive energy or difficulty staying still)

In children with MD, these symptoms may be further complicated by muscle weakness and fatigue, which can make sustained focus and engagement more difficult.

Research suggests a genetic link between DMD and ADHD, as both conditions involve mutations (variations) affecting dystrophin (a protein crucial for muscle and brain function). Studies suggest that 30 percent to 50 percent of people with DMD also experience ADHD.

Managing ADHD usually involves:

• Behavioral therapy
• Consistent routines
• Medications such as stimulants

Treatment plans can help children with ADHD build focus and organization skills, which are important in school and everyday life.

2. Anxiety and Depression

Anxiety and depression are common mental health challenges for people with MD. Living with a progressive disease like MD can lead to feelings of worry, sadness, or hopelessness. Muscle weakness, chronic pain, and the need for caregivers can add to these feelings. As the condition advances, losing the ability to participate in once-enjoyed activities may intensify these emotional struggles.

Managing anxiety and depression often requires a combination of approaches. Options include:

• Therapy
• Support groups
• Medication (such as antidepressants or antianxiety medications)

Working with a counselor or psychologist can provide strategies to cope with emotional distress and improve overall mental health, helping individuals navigate life with MD more confidently.

3. Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition that involves persistent, unwanted thoughts (obsessions) and repetitive behaviors or rituals (compulsions) performed to reduce anxiety. People with MD, especially DMD, have a higher risk for developing OCD. This may be influenced by genetic factors or the stress associated with managing a chronic condition. Research suggests that 6 percent to 12 percent of people with DMD experience OCD.

OCD can show up in different ways. For some people, it may involve worries about their health or future. Others might develop rigid routines around their daily care, such as repeating steps during hygiene tasks.

Treatment for OCD often involves cognitive behavioral therapy (CBT), medication (such as selective serotonin reuptake inhibitors, or SSRIs), or a combination of both. Doctors and therapists create treatment plans that fit the physical and emotional needs of people with MD, making sure the care works well for their situation.

4. Autism Spectrum Disorder

Autism spectrum disorder affects social skills, communication, and behavior, often making it harder for people to connect with others or adapt to changes in their environment. Certain types of muscular dystrophy, especially DMD, are linked to a higher risk of autism spectrum disorder. Researchers believe this may be due to some genetic mutations associated with DMD that could influence brain development, but more studies are needed. Research shows that between 6 percent and 21 percent of people with DMD also have autism spectrum disorder.

Living with both MD and autism spectrum disorder can create challenges with social interactions, communication, and sensory sensitivities. For instance, children with both conditions may find it hard to participate in group activities if physical limitations make it difficult to keep up with peers. Treatment for autism spectrum disorder often includes:

• Behavioral therapy
• Speech therapy
• Occupational therapy, helping people improve their ability to perform daily tasks and live as independently

5. Cognitive Deficits

Cognitive deficits include problems with memory, learning, attention, and executive function (skills like planning and problem-solving). These challenges are common in certain types of muscular dystrophy, particularly DMD. They are linked to genetic mutations associated with MD, which can affect brain development and function. People with MD may also be at higher risk for intellectual disability and behavioral problems, such as impulsivity, aggression, and difficulty with emotional regulation.

In children with DMD, emotional and behavioral challenges, such as dysregulation, are reported in approximately 38 percent of cases. These difficulties can impact social interactions, academic performance, and family dynamics. Addressing both cognitive and behavioral challenges often requires a comprehensive approach to care, including:

• Behavioral therapy
• Counseling
• Individualized educational plans (IEPs) tailored to the child’s needs

Early intervention is key. Working with specialists like neurologists, psychologists, and educators can help families develop effective strategies for supporting children with these challenges. Interventions such as behavioral therapy and educational support can improve quality of life, social skills, and academic outcomes.

6. Epilepsy

Epilepsy is a neurological condition that causes repeated seizures (sudden bursts of electrical activity in the brain). It’s more common in people with certain types of MD, like DMD and Becker muscular dystrophy (BMD), than in the general population. Health experts think that genetic factors affecting both muscle and brain function may increase the risk of epilepsy. In fact, about 1 percent of people with DMD and 3 percent of people with BMD have epilepsy. It’s more common for people with MD who also have cognitive impairment or autism spectrum disorder to experience epilepsy.

Living with both MD and epilepsy can put more strain on the body. Managing epilepsy usually involves anti-seizure medications. Importantly, some of these medications may have side effects that could impact muscle function or interact with other treatments for MD. For this reason, working closely with a neurologist and having regular checkups is crucial to ensure the treatment is effective and tailored to the individual’s needs. Monitoring can help minimize potential complications and support overall health.

7. Obesity

Obesity is a condition commonly diagnosed using body mass index (BMI), which measures weight relative to height. While BMI does not directly measure body fat, obesity generally reflects having a high amount of body fat that can impact health. For most people, a BMI of 30 or higher is classified as obesity.

Obesity is common in people with MD, often due to limited mobility and lower physical activity levels, which can contribute to weight gain. This can lead to additional health problems, including metabolic complications (such as insulin resistance), heart issues like cardiomyopathy (weakening of the heart muscle), and type 2 diabetes.

Studies show that about 20 percent of people with DMD and 14 percent of people with BMD are affected by obesity. However, as muscle atrophy gets worse, the risk of obesity increases. For example, one study in the journal Nutrients found that in boys with DMD, obesity rates rose from 16 percent at age 5 to 50 percent at age 11.

Maintaining a healthy weight can be challenging for those with limited movement, but it is crucial for overall health. A focus on a nutritious, balanced diet and low-impact exercise (such as swimming or adapted physical therapy routines) can help maintain a healthy weight. Your health care team, including dietitians and physical therapists, can help design a plan tailored to a person’s physical abilities and needs.

8. Kidney Stones

Kidney stones are hard deposits made of minerals and salts that form in the kidneys and can be extremely painful to pass. People with limited mobility, such as some of those with MD, may be more likely to develop kidney stones. Reduced physical activity can slow urine flow, allowing minerals to build up and form stones. Researchers have found that around 8 percent of people with DMD and 4 percent of people with BMD develop kidney stones.

Symptoms of kidney stones include:

• Severe pain (often in the back or side)
• Nausea
• Vomiting
• Blood in the urine

People with MD who have kidney stones can find it difficult to manage these symptoms on top of their muscle weakness. To reduce the risk of kidney stones, staying well hydrated and following a low-oxalate diet can help. Foods high in oxalates — substances that contribute to certain types of kidney stones — include spinach, beets, rhubarb, almonds, bran, chocolate, and tea. Limiting these foods, especially in large quantities, can reduce the likelihood of kidney stone formation.

Managing Comorbidities With Muscular Dystrophy

Living with muscular dystrophy often means navigating multiple health challenges. However, with the right care and support, many of these comorbidities can be managed effectively. People with MD and their caregivers should work closely with a health care team, including specialists like neurologists, physical therapists, and psychologists, to monitor for symptoms of these related conditions. Together, they can develop a comprehensive care plan that addresses physical health, mental well-being, and emotional resilience.

Find Your Team

On myMDteam, the social network for people living with muscular dystrophy and their loved ones, members come together to ask questions, give advice, and share their experiences with life and care challenges related to MD.

Do you or your loved one have muscular dystrophy? How have you managed comorbidities like ADHD, anxiety, or epilepsy? Share your story in the comments below, or start a conversation by posting on your Activities page.