Suffering, mental anguish, trembling of the body, and irregular breathing accompany the distractions.

These four symptoms (sahabhuvaḥ = accompaniments) appear along with the obstacles:

1. Duḥkha — Suffering, physical or emotional pain
2. Daurmanasya — Anguish, depression, mental negativity
3. Aṅgamejayatva — Trembling or bodily restlessness
4. Śvāsa-praśvāsa — Irregular breathing (disturbed inhalation and exhalation)

The connection between mind, body, and breath is fundamental in yoga. Mental obstacles manifest physically. Conversely, working with body and breath can help overcome mental obstacles — hence the importance of āsana and prāṇāyāma.