THE CHANGE HER FAMILY DIDN’T SEE COMING — PAMELA CISNEROS SEEMED TO BE GETTING BETTER. THEN EVERYTHING CHANGED.

HER FATHER THOUGHT SHE WAS BACK ON THE RIGHT TRACK. HER FAMILY HAD NO IDEA HOW FAR THINGS HAD CHANGED.

For years, Pamela Cisneros’ family had watched her struggle with serious mental-health problems.

But there was a period when they believed she was finally doing better.

Her father, Mario Cisneros, recently said he had seen his daughter about a week before the Times Square attack and believed she appeared fine.

She was also receiving regular medication injections as part of her treatment.

To her family, it seemed as though Pamela might finally be getting her life back on track.

Then came the changes.

“SHE WASN’T THE SAME”

According to relatives, Pamela had experienced postpartum depression after the birth of her second child.

Her brother, Patrick Peralta, later described a long history of mental-health struggles and said she had been diagnosed with bipolar disorder about a decade ago, although details of her medical diagnosis have not been independently established publicly.

Her family also described years of personal difficulties, including problems within her family relationships.

But there was no indication that anyone expected those struggles to culminate in what happened in Times Square.

Police say that on August 31, Pamela, 49, attacked two strangers in the heart of Manhattan.

One of them was Erin Piacenti, a 32-year-old Bank of America vice president and new mother.

Piacenti had only recently returned to work after five months of maternity leave.

She was on her way through Times Square when her life suddenly crossed paths with a woman she did not know.

THEN ERIN PIACENTI CROSSED HER PATH

The encounter lasted only moments.

But for Erin’s family, those moments changed everything.

Erin was fatally attacked. Another 68-year-old man was also injured but survived.

Police later confronted Cisneros, who was armed with two large knives. Officers attempted to get her to drop them. Police said she then advanced toward officers, and multiple officers deployed Tasers before two officers fired their service weapons.

Cisneros died after being taken to Bellevue Hospital.

The NYPD’s Force Investigation Division is examining the police use of force.

HER FAMILY THOUGHT SHE WAS GETTING BETTER

That is what makes the revelations from her relatives so difficult to process.

Her father said Pamela had been receiving treatment.

Her brother described years of mental-health struggles.

And yet, to the people closest to her, she could still appear to be improving.

Her father said he saw her the week before the attack and believed she was doing well.

There had been warning signs in the past — including previous NYPD encounters involving concerns about her mental health in 2018 and 2019 — but police have not said those incidents explain what happened in Times Square.

That distinction matters.

A history of mental-health problems does not, by itself, explain or predict violent behavior.

And investigators have not publicly established exactly what caused Pamela’s behavior to change.

A LIFE THAT WAS ALREADY UNRAVELING

Cisneros was reportedly a mother of three and had studied psychology, earning a master’s degree.

Her personal life had also gone through major upheaval.

She eventually became estranged from some of her daughters, according to family members, while her marriage ended in divorce.

Those family struggles unfolded alongside her mental-health difficulties.

But the people who knew her say the woman they remembered did not fit the horrifying scene that unfolded in Times Square.

Her father told reporters that she was not a violent person.

Her brother similarly described himself as shocked by what happened.

And now, investigators are left trying to understand what changed.

THEN CAME THE QUESTION NO ONE CAN ANSWER YET

What happened inside Pamela Cisneros’ life between the period when her family believed she was improving and the afternoon she allegedly attacked two strangers?

Did her condition deteriorate?

Were there warning signs her family did not recognize?

Was there a change in her treatment?

Or was something else happening that investigators have not yet uncovered?

Those questions remain unanswered.

Meanwhile, Erin Piacenti’s family is left mourning a 32-year-old woman who had a husband, a five-month-old daughter and a life she was only beginning to build.

HER FAMILY THOUGHT PAMELA WAS BACK ON THE RIGHT TRACK.

THEN, IN THE MIDDLE OF TIMES SQUARE, TWO STRANGERS CROSSED HER PATH — AND ONE OF THEM NEVER MADE IT HOME.