Brother: Times Square Attacker Struggled With Bipolar Disorder

The brother of Pamela Cisneros says she battled postpartum depression and bipolar disorder for two decades but had seemed stable for years before the Times Square attack.

Police say 49-year-old Pamela Cisneros pulled two knives from a Target bag near 41st Street and Seventh Avenue around 4:30 p.m. Piacenti, a Bank of America vice president, died at Bellevue Hospital, while the man was hospitalized in stable condition. Officers confronted Cisneros on Seventh Avenue between 42nd and 43rd streets, spoke to her for four minutes and repeatedly ordered her to drop the knives, according to NYPD Commissioner Jessica Tisch. When Tasers proved ineffective and she advanced, two officers fired and killed her.

Cisneros's brother, Patrick Peralta, told Gothamist that his sister had struggled with what he described as postpartum depression and bipolar disorder for more than 20 years, beginning after the birth of her second daughter. He said she attempted suicide in 2019, after which her condition seemed to improve with monthly psychiatric medication injections. According to the New York Daily News, she threw herself on the subway tracks at the Union Turnpike stop in Queens in 2019. Peralta said he never knew his sister to become violent because of her mental health difficulties, and the family is struggling to understand what propelled the attack.

Peralta said Cisneros had been doing well for the last four to five years, working on and off for an immigration attorney and living in Woodside, and she helped organize their stepfather's birthday gathering in early August — the last time he saw her. The first warning sign came last week, when Cisneros did not show up for the near-daily dinners she usually shared with her mother and stepfather. According to Gothamist, her mother spoke to her by phone on Saturday and Cisneros said she was fine. Peralta told MEAWW News that he suspects she may have missed her last monthly injection and began going off track.

The 68-year-old survivor's wife described to the New York Daily News how the couple, in town from Rhode Island to visit their son, had just exited the Times Square subway station when her husband was attacked from behind. She said she put pressure on his wound and had no hands free to call for help, relying on bystanders to dial 911. The husband was released from Bellevue Hospital on Tuesday. The wife said she empathized with Cisneros's mental health struggles but did not fault officers for shooting her, saying that was their job and training. Witness Linda Ruiz described a man gushing blood and pleading for help.

The NYPD confirmed Cisneros had a documented mental health history with the department involving incidents in 2018 and 2019, though it has not provided further details, and she had no criminal history. Mayor Zohran Mamdani praised the officers who stepped in, saying they prevented a horrific attack from becoming worse. The case lands in a city where violent crime has fallen sharply this year, with homicides down 24 percent and on pace for their lowest level in decades, yet this was the second killing in Times Square in 2026, following a fatal stabbing there in May. Peralta said he is unsure what officers could have done differently once the confrontation began.

Cisneros's family says it is still piecing together how a woman with a master's degree in psychology, three daughters and years of stability could carry out an apparently random attack. Peralta noted her middle daughter is non-verbal and has severe autism and lives at a Brooklyn care home, while the eldest and youngest had been estranged from her for years, living in Florida, according to MEAWW News. Piacenti's employer said she was a valued teammate who will be greatly missed, and Peralta expressed sorrow to both victims' families. The family says it may never learn what triggered the rupture: 'It was like a switch,' he said.