THE CHANGE HER FAMILY DIDN’T SEE COMING — PAMELA CISNEROS’ FAMILY THOUGHT SHE WAS FINALLY GETTING BETTER

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

Her brother said she had experienced postpartum depression after the birth of her second daughter and had battled mental health difficulties for decades.

But there was a period when things appeared to be getting better.

Pamela was receiving treatment. Her family saw her regularly. She worked, lived independently and appeared, to those closest to her, to be doing better.

Her father even believed his daughter had finally turned a corner.

Then, shortly before the Times Square attack, something changed.

“IT WAS LIKE A SWITCH”

Pamela’s brother, Patrick Peralta, said she had seemed stable for several years.

He told reporters that she was receiving regular treatment and that he had never known her to be aggressive.

But then the family noticed something unusual.

Pamela missed a regular family gathering.

It was a small change — but one that worried those who knew her.

Peralta described it as feeling like “a switch” had been flipped, saying he did not understand what had happened in his sister’s mind.

No one in the family appears to have imagined where those changes would lead.

A HISTORY HER FAMILY HAD FOUGHT TO MANAGE

Pamela’s struggles were not new.

Her family has described years of mental health difficulties, including postpartum depression. Her brother also described what he believed was a possible bipolar diagnosis, although public reporting has not established a definitive medical diagnosis.

Her father said Pamela had received ongoing treatment and medication, including regular injections.

For a time, the family believed the treatment was helping.

She was still attending family gatherings. She was still working. She was still living her life.

But according to her father, there were later signs that maintaining treatment had become more difficult.

That history is now being examined alongside the events that unfolded in Manhattan — although authorities have not established that any particular mental health condition or treatment decision caused the attack.

THEN CAME TIMES SQUARE

On Aug. 31, 2026, Pamela, 49, was in the heart of Times Square carrying two large knives.

Police said she first attacked a 68-year-old man before turning toward another stranger.

That stranger was Erin Piacenti.

Erin was 32 years old, a Bank of America vice president, a wife and the mother of a five-month-old daughter.

She had recently returned to work after maternity leave.

Within moments, an ordinary afternoon in New York became a tragedy.

Police said Pamela stabbed Erin in an apparently random and unprovoked attack. Erin was taken to Bellevue Hospital but died from her injuries. The 68-year-old man survived.

THE WOMAN HER FAMILY KNEW — AND THE WOMAN ON THE NEWS

What happened next left Pamela’s family struggling to understand what they were seeing.

Officers confronted her and repeatedly ordered her to drop the knives.

According to police, she refused and advanced toward officers while still armed.

After attempts to stop her with Tasers failed, two officers opened fire.

Pamela was taken to Bellevue Hospital, where she was pronounced dead.

For her family, the woman they saw on television was difficult to reconcile with the Pamela they believed they knew.

Her brother had described someone who had appeared stable for years.

Someone who attended family gatherings.

Someone who, despite a complicated history, had seemed to be moving forward.

THEN THERE WAS ERIN

Erin Piacenti did not know Pamela.

There is no indication the two women had any prior relationship.

Erin was simply walking through Times Square when their paths crossed.

She had a husband, Frank, and a five-month-old daughter, Madison.

She had returned to work after maternity leave and was building a life with her family.

Now her daughter will grow up without her mother.

That is the heartbreaking randomness at the center of this case.

Two completely separate lives.

Two women who apparently had never met.

One moment in Times Square changed everything.

THE QUESTIONS THAT REMAIN

Pamela’s family is now left with questions they may never be able to answer.

What happened in the days before the attack?

Why did she appear to change after years of seeming more stable?

Was there something her family did not see?

And what, if anything, was happening in Pamela’s life immediately before she walked into Times Square?

Investigators have not publicly established a definitive motive.

Police have described the attack as random and unprovoked, and there has been no indication that it was terrorism.

Her family’s account of her mental health history may help explain part of Pamela’s past.

But it does not provide a simple answer for what happened that afternoon.

Because sometimes the most frightening part of a tragedy is realizing how little warning the people closest to someone may have had.

Pamela’s family thought she was getting better.

Then she crossed paths with Erin Piacenti.

And an ordinary afternoon in Times Square became a moment neither family will ever forget.