SHE HAD A MASTER’S DEGREE IN PSYCHOLOGY. NO ONE SAW THIS COMING.

PAMELA CISNEROS APPEARED TO HAVE BUILT A QUIET, PROFESSIONAL LIFE — BUT HER FAMILY SAYS HER LONG BATTLE WITH MENTAL HEALTH HAD TAKEN A TROUBLING TURN BEFORE THE TIMES SQUARE TRAGEDY

To neighbors and relatives, Pamela Cisneros appeared to be an educated professional who had built a relatively quiet life in Queens.

She had earned a master’s degree in psychology and worked on and off with an attorney whose practice focused on immigration cases. Her family said she had spent years managing serious mental-health difficulties, but in recent years she appeared to be doing much better.

Then, shortly before the events that shocked New York City, something changed.

A LIFE THAT APPEARED STABLE

Cisneros, 49, lived alone in Woodside, Queens, and remained close to her mother and stepfather.

Her brother, Patrick Peralta, said she regularly visited the family for meals and had appeared stable for roughly four or five years. During that period, he said, she received medication through injections and had never shown the kind of aggressive behavior that would have made her family fear what was coming.

“She was doing well,” Peralta said, describing his sister as someone the family believed had finally found some stability.

She also had three daughters. Her family life had been complicated, however, and her marriage eventually ended after years of difficulties. Court records show her divorce was finalized in 2025.

Despite those challenges, relatives say Cisneros continued maintaining a routine and staying connected with her family.

Until the final week.

HER FAMILY NOTICED SOMETHING WAS DIFFERENT

Peralta said Cisneros suddenly stopped making her usual visits.

The change alarmed relatives because she had previously been a regular presence at her mother and stepfather’s home.

Family members tried contacting her, and her mother eventually spoke with her by phone on the Saturday before the Times Square incident. According to Peralta, Cisneros said she was fine.

But investigators would soon be trying to understand what had happened during those final days.

Cisneros had a documented mental-health history involving previous encounters with the NYPD, including incidents in 2018 and 2019, according to police officials. Her brother also said she had struggled with serious mental-health problems for years and had attempted suicide in 2019.

QUESTIONS ABOUT HER MEDICATION

One of the biggest unanswered questions involves Cisneros’ treatment.

Her family said medication had helped her remain stable for years. Her father also told reporters that she had eventually become reluctant to continue depending on medication and had stopped attending some mental-health appointments.

Peralta has speculated that she may have missed recent injections.

But that remains a family theory, not an established explanation for what happened.

There is currently no public evidence proving that a missed treatment caused Cisneros’ behavior to change or directly led to the Times Square incident.

That distinction is critical as investigators continue examining her history, actions and possible motive.

THE TIMES SQUARE TRAGEDY

On Aug. 31, police said Cisneros approached two strangers in the heart of Times Square and attacked them with knives.

The first victim was a 68-year-old man who survived.

Moments later, 32-year-old Erin Piacenti, a Bank of America vice president, was attacked. Piacenti was taken to Bellevue Hospital but could not be saved. She had recently returned to work following maternity leave and had been starting her first day back at her job.

Police then confronted Cisneros.

According to NYPD Commissioner Jessica Tisch, officers spent several minutes ordering her to drop the knives. Police said she refused and continued advancing toward officers.

Multiple Tasers were deployed but were ineffective. Two officers ultimately fired their service weapons, striking Cisneros. She was taken to Bellevue Hospital, where she was pronounced dead.

The NYPD’s handling of the confrontation is also being investigated as part of the standard review of an officer-involved shooting.

A FAMILY LEFT ASKING THE SAME QUESTION

For Cisneros’ relatives, the most difficult part may be trying to reconcile the woman they knew with what happened in Times Square.

Her brother said he had never known her to become violent despite her years of mental-health struggles.

A longtime neighbor described her as an “excellent woman” and said he could not understand what had happened to her.

She was a mother, a sister, a daughter and a woman who had earned an advanced degree in psychology.

Yet in the final days of her life, her family noticed that her normal routine had suddenly changed.

Now, investigators are left trying to understand what happened between the woman her family believed was stable and the stranger who appeared in Times Square on Aug. 31.

Whether changes in treatment played any role remains unknown.

And for the families affected by the tragedy, that unanswered question may be one of the hardest to live with.