Should bipolar disorder be considered a systemic illness?

SUMMARY Recent evidence suggests that bipolar disorder is associated with increased rates of medical comorbidities as well as reduced life expectancy. The concept of allostatic load has been instrumental in bridging mental and physical illness and may help us understand the medical burden of bipolar disorder. We review the work of our group and others on this topic and put forward the notion that systemic pathophysiological changes may occur in parallel with the course of bipolar illness.