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I’m playing with the idea of a story that involves a second voice in the main character’s head. I usually distinguish the main character’s thoughts from the story by italicizing the words. With another character’s thoughts in the main character’s head, it gets as confusing as having dialogue back and forth without reminders of which words are coming from which speaker. This works fine in short stretches, but I’d rather have a way to set the second character’s thoughts apart to start with, to be safe.

I’m hesitant about bolding those thoughts, though. For me, bolding makes it stick out too much, and breaks up the (there’s a better way to phrase it) smoothness of reading all normal text. Using a different font could have the same effect if the fonts are too dissimilar. I could color the text, but I’d rather use that if I can’t find a better way. Any ideas?

If you wanted to, you could change the font. Not too much, but just a little bit. Readers notice, but it won't stand out or break the rhythm of the story.

Okaaaay then. DON'T change the font. Ignore me. I'm just a noob.

I wouldn't change the font, color, or make it bold. It'd look pretty unprofessional imo. You could use italics and assign a name or quality to each voice while keeping proper dialogue punctuation. 

No need to reinvent the wheel... or design it incorrectly. 

I'd use italics for the other character's thoughts and just let the POV character's thoughts be self evident as part of the narration.

If they're actually conversing telepathically, then italics for both but otherwise treat it exactly like dialogue.

Also keep aware that anyone using a screen reader can't tell there are font changes. Plus bold and italics mixed would be incredibly annoying to read even the normal way IMO.

Screen readers indicate the use of italics to the user?

They usually don't. I recently noticed an option to speak font attributes in NVDA's settings, so it could be done. But I keep it disabled because it is even more info that I can usually easily get from context. It's not too hard to figure out what's a character's thought and what isn't. And hearing "Bold, text, end of bold" all the time is annoying. I guess I could make a dictionary entry to make it shorter, though.
Besides, I often read stories using braille anyway. I've found no way to see what's in italics on a braille display. And while NVDA does have the option to speak such things, I'm almost certain that other screen readers, such as Talkback, don't.
But there's no need to worry about making things more accessible. Like I said, even if you all decide to use italics for thoughts, I'll understand it just fine using context.

Thanks for the help everyone! I’ll ‘treat it like dialogue’ like mizal suggested.