Mediators of allostasis and systemic toxicity in bipolar disorder

► Bipolar disorder is associated with a high and progressive illness burden related to medical comorbidity, cognitive impairment and premature disability. ► In this report, we argue that allostasis is a meaningful concept in this context, possibly explaining much of the burden associated with bipolar disorder. ► It is explored how traditional mediators of allostasis relate to the systemic dysfunction and pathology found in bipolar disorder.