Progression of bipolar disorder is thought to involve progressive neurobiological changes. There are many individual brain changes, peripheral changes, and molecular and cellular changes that have been linked to the progression of bipolar disorder, and have been investigated as potential biomarkers of progression. An increase in ventricular size, coupled with reduced grey matter volume, appear to be brain changes linked to progression of bipolar disease. It is important to investigate biomarkers of bipolar disorder, and their role in disease progression, in order to better understand the disease process and identify potential new targets for therapies in the future.1